Harrison Benjamin Civin, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

I063255 Issued in NY

Practice address

81 W Main St
Gowanda, NY 14070-1318

Phone

(716) 532-4114

NPI assigned

Aug 26, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rite Aid of New York Inc

  • Community/Retail Pharmacy
  • Gowanda, NY
  • NPI 1205945524
  NPD (past)
• Rite Aid of New York Inc

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1639288129
  NPD (past)

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

{
    "created_epoch": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503705600000",
    "number": "1497272843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 FOXWOOD LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W MAIN ST",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "140701318",
            "telephone_number": "716-532-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVIN",
        "first_name": "HARRISON",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-26",
        "last_updated": "2017-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I063255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooks - TLC Hospital System, Inc.
• Whitney Kay Brooks, RDN
• Amy-Jo Lavay Burroughs, PAC
• Deanna Louise Camizzi, O.T.R.
• Darlene Ann Capozzi, RN
• Ann Marie Cobo, LPN
• Vincent J Coniglio
• Kevin D Cook, LMT
• Lisa Marie Coudrey
• Amy L Damiani, M.D.

• Pharmacist in Gowanda, NY
• Providers in Gowanda, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2017; 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.