Provider Demographics
NPI:1588176796
Name:DEGIULIO'S PHARMACY, INC.
Entity Type:Organization
Organization Name:DEGIULIO'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEGIULIO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-870-2448
Mailing Address - Street 1:220 PORTAGE RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1711
Mailing Address - Country:US
Mailing Address - Phone:716-870-2448
Mailing Address - Fax:
Practice Address - Street 1:220 PORTAGE RD
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1711
Practice Address - Country:US
Practice Address - Phone:716-405-7821
Practice Address - Fax:716-405-7824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy