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General NPI Number Information
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NPI Number | 1497811939
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Entity Type | Organization
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Legal Business Name | GENESEE VALLEY GROUP HEALTH ASSOCIATION
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1850 BRIGHTON HENRIETTA TOWN LINE RD
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City | ROCHESTER
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State | NY
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Zip | 14623-2532
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Country | US
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Telephone | 585-292-8488
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Fax | 585-292-6598
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Provider Business Mailing Address
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Address Line | 1850 BRIGHTON HENRIETTA TOWN LINE RD
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City | ROCHESTER
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State | NY
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Zip | 14623-2532
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Country | US
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Telephone | 585-292-8488
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Fax | 585-292-6598
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MRS. TIFFANY KATHERINE PEPE
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Credential | RPH
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Telephone | 585-292-8488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 017164
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License Number State | NY
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