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General NPI Number Information
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NPI Number | 1275546863
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Entity Type | Organization
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Legal Business Name | ST JOHNS HEALTH CARE CORPORATION
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 03/25/2013
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Provider Practice Location Address
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Address Line | 150 HIGHLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-3024
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Country | US
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Telephone | 585-760-1208
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Fax | 585-760-1543
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Provider Business Mailing Address
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Address Line | 150 HIGHLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-3024
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Country | US
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Telephone | 585-760-1208
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Fax | 585-760-1543
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Authorized Official
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Title or Position | CHIEF PHARMAST
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Name | RICHARD MUFFORD
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Credential | PHARM.D.
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Telephone | 585-760-1439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 022945
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License Number State | NY
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