Newfane Pharmacy Inc.

Organization Active NPI Community/Retail Pharmacy · Newfane, NY

NPI 1851663876 · NPPES record last updated Sep 19, 2025

Key facts

NPI
1851663876
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
031310 (NY)
Legal business name
NEWFANE PHARMACY INC.
Practice address
2780 Main St
Newfane, NY 14108-1237
Phone
(716) 778-0600
Fax
(716) 778-0601
NPI assigned
Feb 7, 2012
Organization subpart
No

Authorized official

Name
Cyrus Ardalan
Title
Owner
Phone
(716) 778-0600

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Medicine Shoppe
2780 Main Street, Newfane, NY 14108 · (716) 778-0600
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Jan 8, 2021

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130222000338 NY DME Supplier - Pharmacy 5395990378 Practice locations: Newfane, NY
O20210108000773 NY Part B Supplier - Mass Immunization (Roster Biller Only) 5395990378 Practice locations: Newfane, NY

National Provider Directory

Locations

2780 Main St
Newfane, NY 14108
Phone (716) 778-0600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 031310 NY Yes

Addresses

Primary practice location

2780 Main St
Newfane, NY 14108-1237

Mailing address

2780 Main Street
Newfane, NY 14108
Phone (716) 778-0600

Other identifiers

IdentifierTypeStateIssuer
2134524OtherPK
04170870MedicaidNY

Other names

  • Newfane Pharmacy Inc. Other name

Other providers in Newfane, NY

All providers in Newfane, NY · Community/Retail Pharmacy in New York

Sources for this page

Verify at the official NPI Registry.