Healthcare Provider Details

I. General information

NPI: 1164583076
Provider Name (Legal Business Name): JAMES JOSEPH RUTOWSKI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 N MAIN ST
WARSAW NY
14569-1343
US

IV. Provider business mailing address

2071 CRITTENDEN RD
ALDEN NY
14004-9617
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-2330
  • Fax:
Mailing address:
  • Phone: 716-937-0205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number039582
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: