Cottrills Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

011114 Issued in NY

Legal business name

COTTRILLS PHARMACY INC

Practice address

255 Main St
Arcade, NY 14009-1214

Phone

(585) 492-2310

Fax

(585) 492-2310

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

David Obrochta

Title

President/Owner

Phone

(716) 508-8481

Specialties & licenses 4

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Cottrills Pharmacy Inc

  • Community/Retail Pharmacy
  • Orchard Park, NY
  • NPI 1487194874

  O20121003000384

  Same enrollment

Locations

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1467521799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MAIN ST",
            "city": "ARCADE",
            "state": "NY",
            "postal_code": "140091214",
            "telephone_number": "585-492-2310",
            "fax_number": "585-492-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MAIN ST",
            "city": "ARCADE",
            "state": "NY",
            "postal_code": "140091214",
            "telephone_number": "585-492-2310",
            "fax_number": "585-492-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTRILLS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "OBROCHTA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "716-508-8481"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "011114",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "011114",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NY",
            "license": "011114",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": "011114",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201398270A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45107301",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00596570",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027458620001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079044300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232725",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093115",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001456",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan E Bierman, RPH
• Angela Rae Blasdell, LPN
• Hilary Ann Borkowski, L.M.T
• Patricia Ann Cleveland, LPN
• Linda E Cole, RPAC
• Dale L. Deahn, M.D., P.C.
• Dale L Deahn, M.D.
• Richard Sheldon Derr, D.D.S.
• Michelle J Dominessy, RPH
• Sara L Eck, LPN

• Community/Retail Pharmacy in Arcade, NY
• Providers in Arcade, 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 Mar 22, 2022; 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.