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General NPI Number Information
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NPI Number | 1720548019
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Entity Type | Organization
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Legal Business Name | IRONDEQUOIT PHARMACY, LLC
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 545 TITUS AVE
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City | ROCHESTER
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State | NY
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Zip | 14617-3154
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Country | US
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Telephone | 585-340-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 545 TITUS AVE
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City | ROCHESTER
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State | NY
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Zip | 14617
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Country | US
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Telephone | 585-340-6440
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Fax | 585-340-6441
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Authorized Official
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Title or Position | OWNER
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Name | DAVID THOMAS SEELMAN
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Credential | PHARMD
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Telephone | 585-269-9720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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