Provider Demographics
NPI:1437609450
Name:ATTICA PHARMACY, INC.
Entity Type:Organization
Organization Name:ATTICA PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVARNWAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-553-6515
Mailing Address - Street 1:2 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:NY
Mailing Address - Zip Code:14011-1024
Mailing Address - Country:US
Mailing Address - Phone:585-591-1111
Mailing Address - Fax:585-591-1112
Practice Address - Street 1:2 MARKET ST
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:NY
Practice Address - Zip Code:14011-1024
Practice Address - Country:US
Practice Address - Phone:585-591-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy