Provider Demographics
NPI:1194824318
Name:ANTHONY-BROWN PHARMACY INC.
Entity type:Organization
Organization Name:ANTHONY-BROWN PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOOREHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-662-3800
Mailing Address - Street 1:4328 S BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2638
Mailing Address - Country:US
Mailing Address - Phone:716-662-3800
Mailing Address - Fax:716-662-3676
Practice Address - Street 1:4328 S BUFFALO ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2638
Practice Address - Country:US
Practice Address - Phone:716-662-3800
Practice Address - Fax:716-662-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0104133336C0003X, 3336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00608273Medicaid
NY0857190001Medicare ID - Type UnspecifiedMEDICARE NUMBER
NY00608273Medicaid