Organization Active NPI

Niagara Apothecary Inc.

  • Community/Retail Pharmacy
  • Niagara Falls, NY
National Provider Identifier
1114932704
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
023249 Issued in NY
Legal business name
NIAGARA APOTHECARY INC.
Practice address
8745 Niagara Falls Blvd.
Niagara Falls, NY 14304-1933
Phone
(716) 297-3530
Fax
(716) 297-3950
NPI assigned
Jul 30, 2006
Last updated
Mar 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Jamie M Latko, RPHNPI 1932203270
Title
Owner/Pharmacist
Phone
(716) 297-3530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 023249 NY Primary

Addresses

Primary practice location

8745 Niagara Falls Blvd.
Niagara Falls, NY 14304-1933

Mailing address

8745 Niagara Falls Blvd.
Niagara Falls, NY 14304-1933
Phone (716) 297-3530

Other identifiers 2

IdentifierTypeStateIssuer
3322601OtherNCPCP
02094273MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930002858 NY DME Supplier - Pharmacy 6305967183 Practice locations: Niagara Falls, NY
O20121019000101 NY Part B Supplier - Mass Immunization (Roster Biller Only) 6305967183 Practice locations: Niagara Falls, NY
O20220419002105 NY Part B Supplier - Pharmacy 6305967183 Practice locations: Niagara Falls, NY

National Provider Directory

National Provider Directory

Locations

8745 Niagara Falls Blvd
Niagara Falls, NY 14304
Phone (716) 297-3530

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1114932704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 NIAGARA FALLS BLVD.",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041933",
            "telephone_number": "716-297-3530",
            "fax_number": "716-297-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 NIAGARA FALLS BLVD.",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041933",
            "telephone_number": "716-297-3530",
            "fax_number": "716-297-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIAGARA APOTHECARY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "LATKO",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "716-297-3530",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "023249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPCP",
            "identifier": "3322601",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02094273",
            "state": "NY"
        }
    ],
    "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 Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.