National Provider Identifier
Portland Pharmacy Inc
Portland Pharmacy Inc is listed in the NPPES registry with a primary specialty of Community/Retail Pharmacy in Rochester, NY and a listed phone number of (585) 537-7081.
Profile Overview
- NPI
- 1033726807
- Provider Type
- Organization
- Primary Specialty
- Community/Retail Pharmacy
- Enumeration Date
- September 25, 2020
- Last Updated
- November 02, 2020
Practice Location
- 1295 Portland Ave Ste 2
- Rochester, NY 14621-2726
Phone: (585) 537-7081
Specialties
- Community/Retail Pharmacy (3336C0003X)
Full Record
- NPI
- 1033726807
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Portland Pharmacy Inc
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 1295 Portland Ave Ste 2
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-2726
- Mailing Country
- US
- Mailing Phone
- (585) 537-7081
- Mailing Fax
- (585) 568-7909
- Practice Street Address
- 1295 Portland Ave Ste 2
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-2726
- Practice Country
- US
- Practice Phone
- (585) 537-7081
- Practice Fax
- (585) 568-7909
- Enumeration Date
- September 25, 2020
- Last Updated
- November 02, 2020
- Authorized Official Last Name
- Shaibi
- Authorized Official First Name
- Malik
- Authorized Official Title
- Supervising Pharmacist
- Authorized Official Phone
- (313) 442-2400
- Organization Subpart
- No
- Authorized Official Credential Text
- RPH
- Certification Date
- November 02, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Community/Retail Pharmacy (3336C0003X)