MEDICARE: MEDICAL ADMINISTRATIVE ASSOCIATES, 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	022533	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2059259	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689693897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL ADMINISTRATIVE ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	777 CLINTON AVE S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-1448
Country	:	US
Telephone Number	:	585-279-4790
Fax Number	:	585-242-7355

Provider Business Practice Location Address
First Line	:	777 CLINTON AVE S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-1448
Country	:	US
Telephone Number	:	585-279-4790
Fax Number	:	585-242-7355

Authorized Official
Title or Position	:	CHIEF OF PHARMACY
Name	:	JASON SMITH
Credential	:	PHARMD
Telephone Number	:	585-785-5193

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/10/2026

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