Organization Active NPI

J Rutowski of Elma Inc

  • Community/Retail Pharmacy
  • Elma, NY
National Provider Identifier
1598848533
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
028512 Issued in NY
Legal business name
J RUTOWSKI OF ELMA INC
Practice address
2317 Bowen Rd
Elma, NY 14059-9497
Phone
(716) 652-3920
Fax
(716) 652-3010
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
John Rutowski, RPH
Title
VP
Phone
(716) 652-3920

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 028512 NY Primary

Addresses

Primary practice location

2317 Bowen Rd
Elma, NY 14059-9497

Mailing address

PO Box 90
2317 Bowen Rd
Elma, NY 14059-0090
Phone (716) 652-3920

Other identifiers 2

IdentifierTypeStateIssuer
2916310MedicaidNY
2058541OtherPK

Other names 1

  • CYS ELMA PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930073164 NY DME Supplier - Pharmacy 4183829088 Practice locations: Elma, NY
O20210112001514 NY Part B Supplier - Pharmacy 4183829088 Practice locations: Elma, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
J Rutowski of Elma Inc2317 Bowen Rd, Elma, NY 14059-9415(716) 652-3920 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Seat Lift Mechanisms|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Tracheotomy Supplies|Urological Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Sep 13, 2007

National Provider Directory

National Provider Directory

Locations

2317 Bowen Rd
Elma, NY 14059
Phone (716) 652-3920

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1598848533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90",
            "address_2": "2317 BOWEN RD",
            "city": "ELMA",
            "state": "NY",
            "postal_code": "140590090",
            "telephone_number": "716-652-3920",
            "fax_number": "716-652-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 BOWEN RD",
            "city": "ELMA",
            "state": "NY",
            "postal_code": "140599497",
            "telephone_number": "716-652-3920",
            "fax_number": "716-652-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J RUTOWSKI OF ELMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "RUTOWSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "716-652-3920",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2916310",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058541",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CYS ELMA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.