Healthcare Provider Details

I. General information

NPI: 1346743549
Provider Name (Legal Business Name): BETSY LYNNE SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 03/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-273-4767
  • Fax:
Mailing address:
  • Phone: 585-273-4767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number051180
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: