Provider Demographics
NPI:1134288640
Name:COMMUNITY MEDICAL PHARMACY INC
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SLEPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-282-1292
Mailing Address - Street 1:918 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305-2608
Mailing Address - Country:US
Mailing Address - Phone:716-282-1292
Mailing Address - Fax:716-285-3723
Practice Address - Street 1:918 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14305-2608
Practice Address - Country:US
Practice Address - Phone:716-282-1292
Practice Address - Fax:716-285-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0151563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00594078Medicaid
NY00594078Medicaid