Provider Demographics
NPI:1174617658
Name:ALLSCRIPT PHARMACY,INC.
Entity type:Organization
Organization Name:ALLSCRIPT PHARMACY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VINTI
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:716-882-0196
Mailing Address - Street 1:173 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14204
Mailing Address - Country:US
Mailing Address - Phone:716-882-0196
Mailing Address - Fax:716-882-0214
Practice Address - Street 1:173 HIGH STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204
Practice Address - Country:US
Practice Address - Phone:716-882-0196
Practice Address - Fax:716-882-0214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0170803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00657974Medicaid
NY3371577OtherNABP
NY00657974Medicaid