Provider Demographics
NPI:1134813454
Name:WURLITZER FAMILY PHARMACY INC.
Entity type:Organization
Organization Name:WURLITZER FAMILY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIROUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-260-1131
Mailing Address - Street 1:521 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-4403
Mailing Address - Country:US
Mailing Address - Phone:716-260-1131
Mailing Address - Fax:716-260-1132
Practice Address - Street 1:521 DIVISION ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-4403
Practice Address - Country:US
Practice Address - Phone:716-260-1131
Practice Address - Fax:716-260-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy