National Provider Identifier

Anthony L. Jordan Health Corporation

Anthony L. Jordan Health Corporation is listed in the NPPES registry with a primary specialty of Federally Qualified Health Center (FQHC) in Rochester, NY and a listed phone number of (585) 423-5800.

NPI 1083716088Rochester, NYFederally Qualified Health Center (FQHC)

Profile Overview

NPI
1083716088
Provider Type
Organization
Primary Specialty
Federally Qualified Health Center (FQHC)
Enumeration Date
September 01, 2006
Last Updated
February 04, 2025

Practice Location

  • 82 Holland Street
  • Rochester, NY 14605-2131

Phone: (585) 423-5800

Mailing Address

  • 82 Holland Street
  • C/O Hr Credenting Dept.
  • Rochester, NY 14605-2131

Specialties

  • Federally Qualified Health Center (FQHC) (261QF0400X)
  • Federally Qualified Health Center (FQHC) (261QF0400X)
Full Record
NPI
1083716088
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Anthony L. Jordan Health Corporation
Mailing Street Address
82 Holland Street
Mailing Address Line 2
C/O Hr Credenting Dept.
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14605-2131
Mailing Country
US
Mailing Phone
(585) 423-2816
Mailing Fax
(585) 423-2853
Practice Street Address
82 Holland Street
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14605-2131
Practice Country
US
Practice Phone
(585) 423-5800
Practice Fax
(585) 423-2890
Enumeration Date
September 01, 2006
Last Updated
February 04, 2025
Authorized Official Last Name
Graham
Authorized Official First Name
Monica
Authorized Official Title
Hr Credentilaing Specialist
Authorized Official Phone
(585) 423-2816
Organization Subpart
No
Certification Date
February 04, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Federally Qualified Health Center (FQHC) (261QF0400X), Federally Qualified Health Center (FQHC) (261QF0400X)
Other Identifiers
G0187295590 (NY, Blue Choice Of Rochester), 16467A (NY, Medicare Part B), 331838 (NY, Medicare Part A), 00384969 (NY), 6613 (NY, Blue Cross Of Rochester)