Provider Demographics
NPI:1023319258
Name:PARKER PHARMACY INC
Entity type:Organization
Organization Name:PARKER PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-725-0887
Mailing Address - Street 1:1388 HERTEL AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2825
Mailing Address - Country:US
Mailing Address - Phone:716-725-0887
Mailing Address - Fax:716-725-0894
Practice Address - Street 1:1388 HERTEL AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-3409
Practice Address - Country:US
Practice Address - Phone:716-725-0887
Practice Address - Fax:716-725-0894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06208126Medicaid
NY030772OtherSTATE LICENSE NUMBER