Organization
CRESTWOOD HEALTH CARE CENTER INC
Active
Other names
CRESTWOOD HCC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LUDWIG (DIRECTOR)
(716) 631-3381
Entity
Organization
Contact information
Practice address
2600 NIAGARA FALLS BLVD, NIAGARA FALLS, NY 14304-4560
(716) 215-8000
(716) 631-3097
Mailing address
1142 WEHRLE DR, WILLIAMSVILLE, NY 14221-7748
(716) 631-3381
(716) 631-8732
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
025365
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3327865
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/14/2006
Last updated
04/23/2010
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