Healthcare Provider Details
I. General information
NPI: 1730213620
Provider Name (Legal Business Name): MICHAEL EDWARD WELSCH R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/15/2007
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 SCOTTSVILLE W HENRIETTA RD SUITE 1
WEST HENRIETTA NY
14586-9596
US
IV. Provider business mailing address
5 SUNLEAF DR
PENFIELD NY
14526-9551
US
V. Phone/Fax
- Phone: 585-334-0140
- Fax: 585-334-5833
- Phone: 585-671-2011
- Fax: 585-334-5833
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 040746 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: