Organization Active NPI

Wellness Park Pharmacy Inc

  • Community/Retail Pharmacy
  • Niagara Falls, NY
National Provider Identifier
1013203488
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
050626 Issued in NY
Legal business name
WELLNESS PARK PHARMACY INC
Practice address
8672 Buffalo Ave
Niagara Falls, NY 14304
Phone
(716) 260-1918
Fax
(716) 260-1917
NPI assigned
Jun 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristina Elmer
Title
President
Phone
(716) 260-1918

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 050626 NY Primary

Addresses

Primary practice location

8672 Buffalo Ave
Niagara Falls, NY 14304

Mailing address

8672 Buffalo Ave
Niagara Falls, NY 14304-4365
Phone (716) 260-1918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120502000288 NY DME Supplier - Pharmacy 5799947040 Practice locations: Niagara Falls, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Wellness Park Pharmacy, Inc8672 Buffalo Ave, Niagara Falls, NY 14304-4365(716) 260-1918 Epoetin|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Feb 13, 2012

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1013203488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8672 BUFFALO AVE",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143044365",
            "telephone_number": "716-260-1918",
            "fax_number": "716-260-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8672 BUFFALO AVE",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "14304",
            "telephone_number": "716-260-1918",
            "fax_number": "716-260-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "ELMER",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-260-1918"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "050626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.