Active NPI
5775 Maelou Drive Operating Company, LLC
- Long Term Care Pharmacy
- Hamburg, NY
National Provider Identifier
1184058083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- 5775 MAELOU DRIVE OPERATING COMPANY, LLC
- Practice address
- 5775 Maelou Dr
Hamburg, NY 14075-7419 - Phone
- (716) 648-2820
- NPI assigned
- Aug 27, 2013
- Last updated
- Jan 19, 2023
- Organization subpart
- Yes
- Parent organization
- 5775 MAELOU DRIVE OPERATING COMPANY, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jeffrey Rubin
- Title
- Co-Chief Executive Officer
- Phone
- (716) 817-5075
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
5775 Maelou Dr
Hamburg, NY 14075-7419
Mailing address
500 Seneca St Ste 100
Buffalo, NY 14204-1963
Phone (716) 633-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031934 | Other | NY | NY BOARD OF PHARMACY REGISTRATION |
National Provider Directory
National Provider Directory- Tax ID family
- 5775 Maelou Drive Operating Company LLC
- Part of
- 5775 Maelou Drive Operating Company LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Elderwood at Hamburg
- Skilled Nursing Facility
- Hamburg, NY
- NPI 1205109949
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
dba Elderwood at Hamburg
- Skilled Nursing Facility
- Hamburg, NY
- NPI 1205109949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674086400000",
"number": "1184058083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 SENECA ST STE 100",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142041963",
"telephone_number": "716-633-3900",
"fax_number": "646-924-0520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5775 MAELOU DR",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140757419",
"telephone_number": "716-648-2820"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "5775 MAELOU DRIVE OPERATING COMPANY, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "5775 MAELOU DRIVE OPERATING COMPANY, LLC",
"enumeration_date": "2013-08-27",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A",
"authorized_official_last_name": "RUBIN",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "CO-CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "716-817-5075",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY BOARD OF PHARMACY REGISTRATION",
"identifier": "031934",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.