Provider Demographics
NPI:1831203520
Name:WASHINGTON PRESCRIPTION CENTER, INC
Entity type:Organization
Organization Name:WASHINGTON PRESCRIPTION CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:716-874-6360
Mailing Address - Street 1:2890 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1325
Mailing Address - Country:US
Mailing Address - Phone:716-874-6360
Mailing Address - Fax:716-874-6369
Practice Address - Street 1:2890 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1325
Practice Address - Country:US
Practice Address - Phone:716-874-6360
Practice Address - Fax:716-874-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0206373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3396745OtherNCPDP
NY01201656Medicaid
NY1253690001Medicare NSC