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General NPI Number Information
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NPI Number | 1609862143
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Entity Type | Organization
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Legal Business Name | MEDICAN GROUP LLC
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7229 ERICA LN SUITE 100
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-4900
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Country | US
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Telephone | 716-692-2020
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Fax | 716-692-5565
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | KENMORE
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State | NY
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Zip | 14217-0008
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Country | US
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Telephone | 716-692-2020
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Fax | 716-692-5565
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. GEOFFREY ZIELINSKI
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Credential | RPH, CGP
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Telephone | 716-692-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 032832
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License Number State | NY
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