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General NPI Number Information
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NPI Number | 1205900685
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Entity Type | Organization
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Legal Business Name | JT TOMPKINS PHARMACIST LLC
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 51 ASSEMBLY DR
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City | MENDON
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State | NY
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Zip | 14506
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Country | US
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Telephone | 585-624-8010
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Fax | 585-624-8019
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Provider Business Mailing Address
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Address Line | PO BOX 654
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City | VICTOR
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State | NY
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Zip | 14564-0654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN TOMPKINS
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Credential |
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Telephone | 585-624-8010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 028088
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License Number State | NY
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