NPIMap

Organization Active NPI

Genesee Valley Group Health Association

Doing business as Lifetime Health Medical Group

  • Institutional Pharmacy
  • Hamburg, NY
National Provider Identifier
1942300231
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
027326 Issued in NY
Legal business name
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Doing business as
Lifetime Health Medical Group
Practice address
151 Elmview Ave
Pharmacy
Hamburg, NY 14075-3762
Phone
(716) 648-3040
Fax
(716) 656-4234
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Cynthia Ambres, MD,MS
Title
President
Phone
(716) 857-6191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 027326 NY Primary

Addresses

Primary practice location

151 Elmview Ave
Pharmacy
Hamburg, NY 14075-3762

Mailing address

151 Elmview Ave
Pharmacy
Hamburg, NY 14075-3762
Phone (716) 648-3040

Other identifiers 3

IdentifierTypeStateIssuer
02619510MedicaidNY
3378747OtherNYNCPDP
027326OtherNYNYS LICENSE NUMBER

Other names 1

  • Lifetime Health Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Daniel B Wopperer52 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942300231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 ELMVIEW AVE",
            "address_2": "PHARMACY",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753762",
            "telephone_number": "716-648-3040",
            "fax_number": "716-656-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 ELMVIEW AVE",
            "address_2": "PHARMACY",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753762",
            "telephone_number": "716-648-3040",
            "fax_number": "716-656-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VALLEY GROUP HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMBRES",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-857-6191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,MS"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NY",
            "license": "027326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02619510",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3378747",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE NUMBER",
            "identifier": "027326",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.