Healthcare Provider Details

I. General information

NPI: 1952364671
Provider Name (Legal Business Name): PHARMHEALTH INFUSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 ALEXANDER ST
ROCHESTER NY
14607-3606
US

IV. Provider business mailing address

172 ALEXANDER ST
ROCHESTER NY
14607-3606
US

V. Phone/Fax

Practice location:
  • Phone: 585-423-9580
  • Fax: 585-423-9488
Mailing address:
  • Phone: 585-423-9580
  • Fax: 585-423-9488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number StateNY

VIII. Authorized Official

Name: MS. SUE KEENAN
Title or Position: DIRECTOR OF NURSING AND OPERATIONS
Credential:
Phone: 585-423-9580