Organization Active NPI

Valley Pharmacy and Medical Supplies, Inc.

  • Community/Retail Pharmacy
  • Gowanda, NY
National Provider Identifier
1871895300
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
048722
Legal business name
VALLEY PHARMACY AND MEDICAL SUPPLIES, INC.
Practice address
31 W Main St
Gowanda, NY 14070-1305
Phone
(716) 982-1264
NPI assigned
Dec 5, 2010
Last updated
Apr 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Mrs. Tammie M Ruzycki, RPHNPI 1023265923
Title
President
Phone
(716) 982-1264

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 048722 Primary

Addresses

Primary practice location

31 W Main St
Gowanda, NY 14070-1305

Mailing address

31 W Main St
Gowanda, NY 14070-1305
Phone (716) 532-1700

Other identifiers 1

IdentifierTypeStateIssuer
00379191MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110819000013 NY DME Supplier - Pharmacy 3476723909 Practice locations: Gowanda, NY
O20170921001849 NY Part B Supplier - Mass Immunization (Roster Biller Only) 3476723909 Practice locations: Gowanda, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Valley Pharmacy & Medical Supplies,31W Main St, Gowanda, NY 14070-1305(716) 532-1700 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Walkers|Orthoses:… Does not accept assignmentParticipating since Jun 10, 2011

National Provider Directory

National Provider Directory

Locations

31 W Main St
Gowanda, NY 14070
Phone (716) 532-1700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1871895300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W MAIN ST",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "140701305",
            "telephone_number": "716-532-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W MAIN ST",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "140701305",
            "telephone_number": "716-982-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PHARMACY AND MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-05",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "RUZYCKI",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-982-1264",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": "048722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00379191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gowanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.