MEDICARE: LINDSEY ANNE SHOALES 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
1	183500000X	Pharmacist	064176	NY

General Provider Information

NPI Number	:	1316426927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY ANNE SHOALES PHARMD.

Provider Business Mailing Address
First Line	:	230 OXFORD ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-2117
Country	:	US
Telephone Number	:	315-506-3714
Fax Number	:

Provider Business Practice Location Address
First Line	:	2161 FAIRPORT NINE MILE PT RD
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-8509
Country	:	US
Telephone Number	:	585-377-1196
Fax Number	:

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

Provider Enumeration Date	:	08/14/2018
Last Update Date	:	08/14/2018

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