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Export Provider Record NPI 1114014164
Vince'S Pharmacy Of Camillus Inc
Organization Subpart: NO
Active
NPI Number1114014164
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1114014164
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-10-09
Last Updated2023-03-07
Authorized OfficialMichael Machen
President
Phone: 3154875775
Mailing Address240 Township Blvd Ste 30
Camillus, NY 13031-1793
United States
Phone: (315) 487-5775 | Fax: (315) 487-4423
📍 View Map
Primary Practice Address240 Township Blvd Ste 30
Camillus, NY 13031-1793
United States
Phone: (315) 487-5775 | Fax: (315) 487-4423
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY00905748
Other (non-Medicare)NY3384928NCPDP #
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies
No3336L0003X – Pharmacy, Long Term Care Pharmacy
Yes3336C0003X – Pharmacy, Community/Retail PharmacyNY018681
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About NPI 1114014164

Vince'S Pharmacy Of Camillus Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1114014164. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Camillus, NY. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-10-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1114014164?

NPI 1114014164 belongs to Vince'S Pharmacy Of Camillus Inc, a Pharmacy, Community/Retail Pharmacy in Camillus, NY. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1114014164 active?

The current status of NPI 1114014164 in the NPPES registry is Active. The record was last updated on 2023-03-07.

What specialty is NPI 1114014164?

NPI 1114014164 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1114014164?

You can verify NPI 1114014164 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1114014164?

The primary practice address on file for NPI 1114014164 is 240 Township Blvd Ste 30, Camillus, NY 13031-1793. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1114014164 issued?

NPI 1114014164 was first issued (enumerated) on 2006-10-09. The NPPES record was last updated on 2023-03-07.

Practice Location Map

Vince'S Pharmacy Of Camillus Inc is located at 240 Township Blvd Ste 30, Camillus, NY. Use the map below to find directions or verify the practice location.

📍 240 Township Blvd Ste 30, Camillus, NY 13031-1793  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Vince'S Pharmacy Of Camillus Inc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1114014164. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy018681NY
Data Verified from CMS NPPES Last synced: 2026-06-26 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162