MEDICARE: DAVID RICHMOND OLSON 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
1	183500000X	Pharmacist	0481741	NY

General Provider Information

NPI Number	:	1811924996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID RICHMOND OLSON RPH

Provider Business Mailing Address
First Line	:	1245 SOUTH AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2816
Country	:	US
Telephone Number	:	585-461-3154
Fax Number	:

Provider Business Practice Location Address
First Line	:	2613 W HENRIETTA RD
Second Line	:	STRONG TIES PHARMACY
City	:	ROCHESTER
State	:	NY
Zip	:	14623-2327
Country	:	US
Telephone Number	:	585-279-4950
Fax Number	:	585-461-3942

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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