Healthcare Provider Details

I. General information

NPI: 1790769883
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: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 1ST NORTH ST ATTN: PHARMACY MANAGER
SYRACUSE NY
13208-2180
US

IV. Provider business mailing address

1500 BROOKS AVE ATTN: PHARMACY OFFICE
ROCHESTER NY
14624-3512
US

V. Phone/Fax

Practice location:
  • Phone: 315-476-9954
  • Fax: 315-471-0006
Mailing address:
  • Phone: 585-237-9435
  • Fax: 585-239-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number019729
License Number StateNY

VIII. Authorized Official

Name: JULIE LENHARD
Title or Position: DIRECTOR OF MANAGED CARE
Credential: RPH
Phone: 585-239-2001