Wolcott Village Pharmacy Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

040702 Issued in NY

Legal business name

WOLCOTT VILLAGE PHARMACY INC

Practice address

12026 E Main St
Wolcott, NY 14590-1022

Phone

(315) 594-1212

Fax

(315) 594-2971

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Donald Thomas ColleaNPI 1073837308

Title

Owner Supervising Pharmacist

Phone

(315) 594-1212

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Donald Collea

  • Pharmacist
  • Wolcott, NY
  • NPI 1073837308
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1720129448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12026 E MAIN ST",
            "city": "WOLCOTT",
            "state": "NY",
            "postal_code": "145901022",
            "telephone_number": "315-594-1212",
            "fax_number": "315-594-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12026 E MAIN ST",
            "city": "WOLCOTT",
            "state": "NY",
            "postal_code": "145901022",
            "telephone_number": "315-594-1212",
            "fax_number": "315-594-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLCOTT VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "COLLEA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "315-594-1212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "040702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01904796",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "3301998",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "024126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Welkley
• Melissia Wheeler, R.N.
• Michael Wittek, RPA
• Wolcott Area Volunteer Ambulance Corp, Inc.
• Wolcott Pharmacy LLC
• James Michael Yadanza, D.C.

• All providers in Wolcott, NY
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.