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NPI Code Detail

MEDICARE: DIANE LAWATSCH RPH

MEDICARE: DIANE LAWATSCH 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
1183500000XPharmacist038674NY

General Provider Information

NPI Number : 1316261837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE LAWATSCH RPH
Provider Business Mailing Address
First Line : 6600 PITTSFORD PALMYRA RD
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-3404
Country : US
Telephone Number : 585-223-0743
Fax Number : 585-223-0743
Provider Business Practice Location Address
First Line : 6600 PITTSFORD PALMYRA RD
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-3404
Country : US
Telephone Number : 585-223-0743
Fax Number : 585-223-0743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2010
Last Update Date : 03/26/2010

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