Provider Demographics
NPI:1558975805
Name:TODAMAR INC
Entity Type:Organization
Organization Name:TODAMAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-433-3733
Mailing Address - Street 1:320 S TRANSIT ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-4848
Mailing Address - Country:US
Mailing Address - Phone:716-433-3733
Mailing Address - Fax:716-433-3720
Practice Address - Street 1:320 S TRANSIT ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-4848
Practice Address - Country:US
Practice Address - Phone:716-433-3733
Practice Address - Fax:716-433-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01981488Medicaid