PENN TRAFFIC COMPANY THE (NPI# 1063433399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063433399 |
| Entity Type | Organization |
| Organization Name | PENN TRAFFIC COMPANY THE |
| Other Organization Name | P AND C FOOD AND PHARMACY 3025 |
| Practice Address |
7785 Frontage Rd Cicero NY 13039-8637 |
| Practice Telephone | 3154521048 |
| Practice Fax Number | 3152140018 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES ERBA (PHARMACY SYSTEMS MANAGER) |
| Authorized Official Telephone | 3154612595 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 022068 | NY | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01254902 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3399385 | 01 |
| Other Name | Type Code |
|---|---|
| P AND C FOOD AND PHARMACY 3025 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518988849 | Penn Traffic Company The | Pharmacy | 3577 W Genesee St, Syracuse, NY 13219-2002 | 2006-07-21 |
| 1154342483 | Penn Traffic Company The | Pharmacy | 152 Harte Haven Plz, Massena, NY 13662-2608 | 2006-07-21 |
| 1790706026 | Penn Traffic Company The | Pharmacy | 2078 State Route 481, Fulton, NY 13069 | 2006-07-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | PENN TRAFFIC COMPANY THE | Po Box 4737, Syracuse, NY 13221 |
| Street Address |
7785 FRONTAGE RD |
| City | CICERO |
| State | NY |
| Zip Code | 13039-8637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238212 | Cody Hodgson | Physician Assistant | 6993 Van Antwerp Drive, East, Cicero, NY 13039 | 2019-08-01 |
| 1164989810 | Emily Grace Massey | Occupational Therapy Assistant | 5962 Rte 31, Cicero, NY 13039 | 2019-02-28 |
| 1356837512 | Jennifer Lonnen Dds Pllc | Dentist | 6221 Rt 31 Ste 102, Cicero, NY 13039 | 2018-07-10 |
| 1285186916 | Bismarck Np Psychiatric Services Pllc | Nurse Practitioner | 6221 Route 31, Suite 106, Cicero, NY 13039 | 2016-10-28 |
| 1386090397 | Kristin Raineri | Dentist | 5972 Rt 31, Cicero, NY 13039 | 2016-05-09 |
| 1053788281 | Empire Vision Center, Inc | Eyewear Supplier (Equipment, not the service) | 5653 East Circle Drive, Cicero, NY 13039 | 2015-08-24 |
| 1003251018 | Christina M Smith | Licensed Practical Nurse | 8449 Bayridge Rd, Cicero, NY 13039 | 2013-05-03 |
| 1134463433 | Margaret L Southard | Case Manager/Care Coordinator | 5962 Rt 31, Suite 7 Box 10, Cicero, NY 13039 | 2012-11-27 |
| 1245589852 | Samantha Danielle Dillon | Pharmacist | 8061 Brewerton Road, Cicero, NY 13039 | 2012-08-29 |
| 1861769168 | Laura Shaw | Counselor | 6221 Rt. 31, Suite 110, Cicero, NY 13039 | 2011-11-30 |
| Find all providers in zip 13039 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386751568 | Kph Healthcare Services, Inc. | Pharmacy | 8150 Thompson Rd, Cicero, NY 13039-9379 | 2006-08-24 |
| 1457335556 | Wegmans Food Markets, Inc. | Pharmacy | 7954 Brewerton Rd, Attn: Pharmacy Manager, Cicero, NY 13039-9583 | 2005-12-01 |
| 1417060823 | Golub Corporation | Pharmacy | 5701 E Circle Dr, Cicero, NY 13039-8638 | 2006-08-17 |
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| 1609486562 | Phils Pill Pharmacy, Inc | Pharmacy | 8387 Woodhaven Blvd, Jamaica, NY 11421-1533 | 2020-08-05 |
| 1679182349 | Marvel Pharmacy Inc | Pharmacy | 9612 Liberty Ave, Ozone Park, NY 11417-1624 | 2020-07-28 |
| 1114545837 | Edgar Murcia | Pharmacy | 7702 Roosevelt Ave Ste C, Jackson Heights, NY 11372-6604 | 2020-07-09 |
| 1811513724 | Link Pharmacy | Pharmacy | 456 Avenue P, Brooklyn, NY 11223-2895 | 2020-06-17 |
| 1396361259 | Banani Road 11 LLC | Pharmacy | 181-04 Hillside Ave, Jamaica, NY 11432 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.