Healthcare Provider Details

I. General information

NPI: 1336499656
Provider Name (Legal Business Name): JENNIFER WARRINGTON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 TAYLOR ROAD
DEPEW NY
14043
US

IV. Provider business mailing address

124 TAYLOR ROAD
DEPEW NY
14043
US

V. Phone/Fax

Practice location:
  • Phone: 716-635-5991
  • Fax:
Mailing address:
  • Phone: 716-635-5991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI055036
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: