Genesee Valley Group Health Assoc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

PH29885 Issued in FL

Legal business name

GENESEE VALLEY GROUP HEALTH ASSOC

Doing business as

Lifetime Health Medical Group

Practice address

899 Main St
Buffalo, NY 14203-1109

Phone

(716) 885-2833

Fax

(716) 422-2808

NPI assigned

Jul 22, 2006

Last updated

Aug 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen Urbanski, RPH

Title

Manager, Pharmacy Services

Phone

(716) 689-3420

Specialties & licenses 8

Addresses

Other identifiers 2

Other names 1

• LIFETIME HEALTH MEDICAL GROUP Doing business as

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1841211802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 SWEET HOME RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261018",
            "telephone_number": "716-689-3420",
            "fax_number": "716-689-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031109",
            "telephone_number": "716-885-2833",
            "fax_number": "716-422-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VALLEY GROUP HEALTH ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "URBANSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "MANAGER, PHARMACY SERVICES",
        "authorized_official_telephone_number": "716-689-3420",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "027323",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "FL",
            "license": "PH29885",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02619501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065029",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFETIME HEALTH MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• General Physician Sub II PLLC
• General Physician Sub III PLLC
• General Physician Sub IV PLLC
• Genesee Hearing Services
• Genesee Valley Group Health (Lifetime Health Medical Group)
• Genesee Valley Group Health Association (Lifetime Health Medical Group)
• Genesee Valley Group Health Association (Lifetime Health Medical Group)
• Genesis Chiropractic, P.C.
• Genessee Valley Group Health Assoc (Lifetime Health Medical Group)
• Anthony Gengo, PA-C

• Clinic Pharmacy in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinic Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.