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KENMORE RX CENTER
NPI 1871587337
Pharmacist in Kenmore, NY

Active since September 09, 2005CLIA 33D2185436 · Waiver
2818 DELAWARE AVENUE, KENMORE, NY 14217(716) 874-6360(716) 874-6369 Get Directions Write a Review

NPPES record last updated: March 15, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kenmore Rx Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENMORE RX CENTER (NPI 1871587337) is a healthcare organization registered as a pharmacist in Kenmore, New York and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Jeffrey Michael Rutowski, Pharmacist / Part-owner, as its authorized official.

NPPES Registry Identity

NPI1871587337
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameRUTOWSKI OF KENMORE INC
Location Address2818 DELAWARE AVENUEKenmore, NY 14217
Mailing Address2818 Delaware AvenueKenmore, NY 14217 · (716) 874-6360 · Fax (716) 874-6369
Phone(716) 874-6360
Fax(716) 874-6369
Organization SubpartNo
Authorized OfficialJeffrey Michael RutowskiPharmacist / Part-owner · (716) 874-6360
Enumeration DateSeptember 9, 2005
Last NPPES UpdateMarch 15, 2018
✔ NPI 1871587337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in NY · 024886
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
2818 DELAWARE AVENUE, Kenmore, NY 14217
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Other Names 1

Doing Business AsKenmore Rx Center

Other Identifiers 2

Other3311317NM · Ncpdp
Medicaid02144470NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenmore Rx Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20190220000354DME · PharmacyDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2185436

Kenmore Rx Center · Kenmore, NY
Active · expires Mar 26, 2027
CLIA Number33D2185436
Laboratory TypePharmacy
Certificate Effective DateJune 3, 2020
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorJerome M. Rutowski
Laboratory Phone(716) 874-6360
Laboratory LocationKenmore Rx Center2818 Delaware Ave, Kenmore, NY 14217
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
47 services46 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
43 services42 patients
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home M0201
The Covid-19 vaccine can be administered at your home for convenience and safety. This service is reported once per home, per date, when only the vaccine is given. It's a straightforward process where a medical professional visits your home to give the vaccine.
28 services26 patients

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Kenmore Rx Center carries, from the Medicare DMEPOS supplier directory.

Kenmore Rx Center

DMEPOS supplier · Kenmore, NYOperated by Rutowski Of Kenmore Inc
⋮

Does not accept Medicare assignment

Kenmore Rx Center has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20453393
Medicare Participant SinceSeptember 24, 2018
Supplier Location2818 Delaware AveKenmore, NY 14217
Phone(716) 874-6360
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rutowski Of Kenmore Inc's NPI number?

The NPI number for Rutowski Of Kenmore Inc is 1871587337. It was assigned to this organization in the NPPES registry on September 9, 2005. The provider is doing business as Kenmore Rx Center.

Where is Rutowski Of Kenmore Inc located?

Rutowski Of Kenmore Inc is located at 2818 Delaware Avenue, Kenmore, NY 14217. The listed phone number is (716) 874-6360.

What is Rutowski Of Kenmore Inc's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Is Rutowski Of Kenmore Inc enrolled in Medicare?

Yes. Rutowski Of Kenmore Inc is registered in the Medicare PECOS enrollment system.

When is Rutowski Of Kenmore Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (New York, Pharmacy) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Rutowski Of Kenmore Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Kenmore Rx Center does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Rutowski Of Kenmore Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2185436) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Rutowski Of Kenmore Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 42 other insurers list Rutowski Of Kenmore Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rutowski Of Kenmore Inc was last updated on March 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.