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NPI Code Detail

MEDICARE: DR. KEVIN JAMES CALLAHAN JR. PHARMD

MEDICARE: DR. KEVIN JAMES CALLAHAN JR. PHARMD
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
1183500000XPharmacist063051NY

General Provider Information

NPI Number : 1275162166
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN JAMES CALLAHAN JR. PHARMD
Provider Business Mailing Address
First Line : 677 GRAND AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14609-6534
Country : US
Telephone Number : 585-703-2687
Fax Number :
Provider Business Practice Location Address
First Line : 2580 E HENRIETTA RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-4526
Country : US
Telephone Number : 585-703-2687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2020
Last Update Date : 04/03/2020

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