MEDICARE: ACM MEDICAL LABORATORY INC

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	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174517353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACM MEDICAL LABORATORY INC

Provider Business Mailing Address
First Line	:	160 ELMGROVE PARK
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1359
Country	:	US
Telephone Number	:	585-429-2289
Fax Number	:	585-247-2797

Provider Business Practice Location Address
First Line	:	160 ELMGROVE PARK
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1359
Country	:	US
Telephone Number	:	585-429-2289
Fax Number	:	585-247-2797

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MS. GITA RAMACHANDRAN
Credential	:
Telephone Number	:	585-429-2225

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	02/13/2015

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