Healthcare Provider Details

I. General information

NPI: 1316271695
Provider Name (Legal Business Name): HIGHLANDER HEALTHCARE SUPPLY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2009
Last Update Date: 09/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 GOODMAN ST S
ROCHESTER NY
14620-2523
US

IV. Provider business mailing address

847 GOODMAN ST S
ROCHESTER NY
14620-2523
US

V. Phone/Fax

Practice location:
  • Phone: 585-442-0677
  • Fax:
Mailing address:
  • Phone: 585-442-0677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID THOMAS PRZYBYSZEWSKI
Title or Position: PRESIDENT
Credential:
Phone: 585-442-0677