Provider Demographics
NPI:1457348708
Name:RUTOWSKI OF ALDEN INC
Entity Type:Organization
Organization Name:RUTOWSKI OF ALDEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-861-2226
Mailing Address - Street 1:13203 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-1312
Mailing Address - Country:US
Mailing Address - Phone:716-937-9818
Mailing Address - Fax:716-934-4073
Practice Address - Street 1:13203 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-1312
Practice Address - Country:US
Practice Address - Phone:716-937-9818
Practice Address - Fax:716-934-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01018506Medicaid
NY0299000001Medicare NSC