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 1174095640Rochester, NYFederally Qualified Health Center (FQHC)

Profile Overview

NPI
1174095640
Provider Type
Organization
Primary Specialty
Federally Qualified Health Center (FQHC)
Enumeration Date
December 21, 2018
Last Updated
December 21, 2018

Practice Location

  • 214 Lake Ave
  • Rochester, NY 14608-1208

Phone: (585) 423-5800

Mailing Address

  • 214C Lake Ave
  • Rochester, NY 14608-1208

Specialties

  • Federally Qualified Health Center (FQHC) (261QF0400X)
Full Record
NPI
1174095640
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Anthony L. Jordan Health Corporation
Mailing Street Address
214C Lake Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14608-1208
Mailing Country
US
Mailing Phone
(585) 423-2816
Mailing Fax
(585) 423-2853
Practice Street Address
214 Lake Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14608-1208
Practice Country
US
Practice Phone
(585) 423-5800
Practice Fax
(585) 784-5981
Enumeration Date
December 21, 2018
Last Updated
December 21, 2018
Authorized Official Last Name
Graham
Authorized Official First Name
Monica
Authorized Official Middle Name
M.
Authorized Official Title
Billing Manger
Authorized Official Phone
(585) 423-2821
Organization Subpart
No
Authorized Official Credential Text
CMBS, CMC
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Federally Qualified Health Center (FQHC) (261QF0400X)