Provider Demographics
NPI:1730109646
Name:BUFFALO PHARMACIES, INC.
Entity type:Organization
Organization Name:BUFFALO PHARMACIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:VOELKL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-832-0599
Mailing Address - Street 1:1479 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1436
Mailing Address - Country:US
Mailing Address - Phone:716-832-0599
Mailing Address - Fax:716-832-5214
Practice Address - Street 1:813 FAY RD STE P1
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13219-3009
Practice Address - Country:US
Practice Address - Phone:315-401-4500
Practice Address - Fax:315-401-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
NY0216023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3372721OtherNABP
NY00997113Medicaid
NY021602OtherSTATE LICENSE
NY00997113Medicaid