Active NPI
Clarence Pharmacy LLC
- Community/Retail Pharmacy
- Clarence, NY
National Provider Identifier
1679923866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 034628
- Legal business name
- CLARENCE PHARMACY LLC
- Practice address
- 9500 Main St Ste 600
Clarence, NY 14031-1981 - Phone
- (716) 407-3544
- Fax
- (716) 407-3543
- NPI assigned
- Jun 17, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kevin Clary, BS PHARMACY
- Title
- Supervising Pharmacist
- Phone
- (716) 407-3544
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 034628 | NY | Primary |
Addresses
Primary practice location
9500 Main St Ste 600
Clarence, NY 14031-1981
Mailing address
9500 Main St Ste 600
Clarence, NY 14031-1981
Phone (716) 407-3544
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04988758 | Medicaid | NY | |
| 2160758 | Other | PK |
Other names 1
- Clarence Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180724001821 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 0941560684 | Practice locations: Clarence, NY |
National Provider Directory
National Provider DirectoryLocations
9500 Main St
Ste 600
Clarence, NY 14031
Phone (716) 407-3544
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Clarence, NY
- NPI 1609052091
-
- Pharmacist
- Williamsville, NY
- NPI 1861674202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750204800000",
"number": "1679923866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 MAIN ST STE 600",
"city": "CLARENCE",
"state": "NY",
"postal_code": "140311981",
"telephone_number": "716-407-3544",
"fax_number": "716-407-3543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 MAIN ST STE 600",
"city": "CLARENCE",
"state": "NY",
"postal_code": "140311981",
"telephone_number": "716-407-3544",
"fax_number": "716-407-3543"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARENCE PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-17",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A",
"authorized_official_last_name": "CLARY",
"authorized_official_first_name": "KEVIN",
"authorized_official_title_or_position": "SUPERVISING PHARMACIST",
"authorized_official_telephone_number": "716-407-3544",
"authorized_official_credential": "BS PHARMACY"
},
"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": "034628",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04988758",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2160758",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Clarence Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Clarence, NY
- Timothy Paul Chambers, EDD
- Molly Michele Champagne-Forte, LMT
- Christian Counseling Ministries of Western New York Inc
- Clarence Cardiology LLC
- Clarence Central School District
- Kevin Morse Clary, RPH
- Melissa Cleveland
- Victor Imanol Aberri Colon de Dendariarena IV, LMHC-P
- Nancy R Corigliano
- David J. Lewis DC PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.