Black Rock Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

BLACK ROCK PHARMACY INC

Doing business as

Black Rock Pharmacy

Practice address

431 Tonawanda St
Buffalo, NY 14207-2625

Phone

(716) 876-3070

Fax

(716) 876-7464

NPI assigned

May 14, 2019

Organization subpart

No

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

Authorized official

Name

Bradley John Arthur, RPHNPI 1336350685

Title

Owner

Phone

(716) 876-3070

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Black Rock Pharmacy Doing business as

Locations

Practitioners 3

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

• Bradley John Arthur, RPH

  • Pharmacist
  • Buffalo, NY
  • NPI 1336350685
  NPD Authorized official
• Michael A Manuszewski, RPH

  • Pharmacist
  • Buffalo, NY
  • NPI 1801942115
  NPD (past)
• Katherine Colleen Sullivan, PHARMD

  • Pharmacist
  • Tonawanda, NY
  • NPI 1023621422
  NPD (past)

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1457917544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 TONAWANDA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142072625",
            "telephone_number": "716-876-3070",
            "fax_number": "716-876-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 TONAWANDA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142072625",
            "telephone_number": "716-876-3070",
            "fax_number": "716-876-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ROCK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "ARTHUR",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-876-3070",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00591864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Rock Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dimitra Ekonomidis Bitikofer, PHARMD
• Mary Bittner
• Corinne Nicole Bivolcic
• Cynthia Bizari, PTA
• Black Rock Mental Counseling Wny, PLLC
• Black Rock Pharmacy Inc
• Barbara Ellen Black, RN
• Florence Black
• Leah Black, D.O.
• Ruth Theresa Black, LCSW-R

• Long Term Care Pharmacy in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.