Organization Active NPI

Clarence Pharmacy LLC

  • Community/Retail Pharmacy
  • Clarence, NY
National Provider Identifier
1679923866
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
034628 Issued in NY
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

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Kevin Clary, BS PHARMACYNPI 1609052091
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
04988758MedicaidNY
2160758OtherPK

Other names 1

  • Clarence Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180724001821 NY Part B Supplier - Mass Immunization (Roster Biller Only) 0941560684 Practice locations: Clarence, NY

National Provider Directory

National Provider Directory

Locations

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.

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

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.

Verify at the official NPI Registry.