Olde Canal Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

022482 Issued in NY

Legal business name

OLDE CANAL PHARMACY INC

Practice address

201 Scottsville W Henrietta Rd
West Henrietta, NY 14586-9596

Phone

(585) 889-3510

Fax

(585) 334-5833

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Michael WelschNPI 1730213620

Title

President

Phone

(585) 889-3510

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MILLERS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

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

Locations

Practitioners 3

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

• Michael Edward Welsch, R.PH.

  • Pharmacist
  • West Henrietta, NY
  • NPI 1730213620
  NPD Authorized official
• Lewanne F Nettles, RPH

  • Pharmacist
  • West Henrietta, NY
  • NPI 1912238031
  NPD (past)
• Salvatore Anthony Sack, RPH

  • Pharmacist
  • W Henrietta, NY
  • NPI 1598889164
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1811033426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SCOTTSVILLE W HENRIETTA RD",
            "address_2": "SUITE 1",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869596",
            "telephone_number": "585-889-3510",
            "fax_number": "585-334-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SCOTTSVILLE W HENRIETTA RD",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869596",
            "telephone_number": "585-889-3510",
            "fax_number": "585-334-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDE CANAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "WELSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-889-3510"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "022482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2057593",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01569171",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monique Moore, LPN
• Nyckiyah Jahni Mulkey, RN
• Stephen William Nemeth, PHARMD
• Lewanne F Nettles, RPH
• Nursing Facility
• Andy Oshiopekhai Oshiotse, LPN
• Lakeya Owens
• Yesha Patel
• Pharmacy Corporation of America
• Pharmadva LLC

• Long Term Care Pharmacy in West Henrietta, NY
• Providers in West Henrietta, NY by specialty
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.