Healthcare Provider Details

I. General information

NPI: 1801410683
Provider Name (Legal Business Name): UNIVERSITY OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 S CLINTON AVE STE 400
ROCHESTER NY
14618-5719
US

IV. Provider business mailing address

155 BELLWOOD DR
ROCHESTER NY
14606-4226
US

V. Phone/Fax

Practice location:
  • Phone: 585-276-4663
  • Fax:
Mailing address:
  • Phone: 585-274-3036
  • 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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY J WARNER
Title or Position: ASSOCIATE DIRECTOR
Credential: RPH
Phone: 585-274-3036