Healthcare Provider Details

I. General information

NPI: 1366426462
Provider Name (Legal Business Name): WEGMANS FOOD MARKETS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4979 W TAFT RD ATTN: PHARMACY MANAGER
LIVERPOOL NY
13088-4811
US

IV. Provider business mailing address

1500 BROOKS AVE ATTN: PHARMACY OFFICE
ROCHESTER NY
14624
US

V. Phone/Fax

Practice location:
  • Phone: 315-457-4570
  • Fax: 315-451-5744
Mailing address:
  • Phone: 585-239-2009
  • Fax: 585-239-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number019714
License Number StateNY

VIII. Authorized Official

Name: ERIN HEINTZ
Title or Position: SECRETARY
Credential:
Phone: 585-429-3902