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General NPI Number Information
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NPI Number | 1851380679
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Entity Type | Organization
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Legal Business Name | FILLMORE & FISHER PHARMACY, INC
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 12/31/2020
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Provider Practice Location Address
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Address Line | 138 N MAIN ST
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City | WELLSVILLE
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State | NY
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Zip | 14895-1151
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Country | US
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Telephone | 585-593-2611
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Fax | 585-593-1903
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Provider Business Mailing Address
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Address Line | 138 N MAIN ST
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City | WELLSVILLE
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State | NY
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Zip | 14895-1151
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Country | US
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Telephone | 585-593-2611
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Fax | 585-593-1903
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. RICK L WONDERLING
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Credential | RPH.
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Telephone | 585-593-2611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 014331
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License Number State | NY
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