Village Pharmacy of Lockport, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VILLAGE PHARMACY OF LOCKPORT, INC.

Practice address

6478 Ridge Rd
Lockport, NY 14094-1015

Phone

(716) 302-3434

Fax

(716) 727-3302

NPI assigned

Jan 7, 2022

Organization subpart

No

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

Authorized official

Name

Cyrus Ardalan, RPH

Title

Supervising Pharmacist

Phone

(716) 796-5668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1194486548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6478 RIDGE RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140941015",
            "telephone_number": "716-302-3434",
            "fax_number": "716-727-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6478 RIDGE RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140941015",
            "telephone_number": "716-302-3434",
            "fax_number": "716-727-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PHARMACY OF LOCKPORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "ARDALAN",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "716-796-5668",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Jensen Vanduluitgaarden
• Connor Vanko, PA
• Mark Varallo, MD
• Nicholas Varallo, MD
• Vigel Varkey, M.D.
• Krista Morie Vince Garland
• Lawrence E Volland, DDS
• Jennifer L. Vorholzer, L.M.T.
• Margaret Wager, RN
• Donnie R Waits, LPN, PDN, A.S.

• Community/Retail Pharmacy in Lockport, NY
• Providers in Lockport, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.