MEDICARE: JULIE ANN LEARY RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	046004-1	NY

General Provider Information

NPI Number	:	1134453673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN LEARY RPH

Provider Business Mailing Address
First Line	:	6 WOLFBORO DR
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-9381
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 E. RIDGE RD
Second Line	:	WEGMAN'S PHARMACY
City	:	ROCHESTER
State	:	NY
Zip	:	14450
Country	:	US
Telephone Number	:	585-342-6388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	10/01/2009

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