Provider Demographics
NPI:1326823741
Name:GGG61 CORP
Entity Type:Organization
Organization Name:GGG61 CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:GIAMBRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-672-8400
Mailing Address - Street 1:10220 ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-1458
Mailing Address - Country:US
Mailing Address - Phone:716-672-8400
Mailing Address - Fax:716-672-8420
Practice Address - Street 1:10220 ROUTE 60
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-1458
Practice Address - Country:US
Practice Address - Phone:716-672-8400
Practice Address - Fax:716-672-8420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy