Healthcare Provider Details

I. General information

NPI: 1912189333
Provider Name (Legal Business Name): REBECCA L MORRIS R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 N MAIN ST
JAMESTOWN NY
14701-3550
US

IV. Provider business mailing address

516 VALERIE LN
JAMESTOWN NY
14701-9402
US

V. Phone/Fax

Practice location:
  • Phone: 716-487-0102
  • Fax:
Mailing address:
  • Phone: 716-664-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042619
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: