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General NPI Number Information
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NPI Number | 1033320171
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Entity Type | Individual
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Provider Name | LINDA M MOMBERGER RPH
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 N MAIN ST
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City | WARSAW
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State | NY
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Zip | 14569-1025
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Country | US
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Telephone | 585-786-2233
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Fax | 585-786-1240
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Provider Business Mailing Address
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Address Line | 14 PICKETT STREET EXT
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City | CASTILE
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State | NY
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Zip | 14427-9707
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Country | US
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Telephone | 585-493-2028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 036771-1
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License Number State | NY
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