Healthcare Provider Details

I. General information

NPI: 1093704843
Provider Name (Legal Business Name): FILLMORE & FISHER PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10560 ROUTE 19
FILLMORE NY
14735-8703
US

IV. Provider business mailing address

PO BOX 272
FILLMORE NY
14735-0272
US

V. Phone/Fax

Practice location:
  • Phone: 585-567-2228
  • Fax: 585-567-8227
Mailing address:
  • Phone: 585-567-2228
  • Fax: 585-567-8227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number013716
License Number StateNY

VIII. Authorized Official

Name: ALYSSA VELEZ
Title or Position: OWNER
Credential: PHARMD
Phone: 585-567-2228