National Provider Identifier
Anthony L. Jordan Health Corporation
Anthony L. Jordan Health Corporation is listed in the NPPES registry with a primary specialty of Community/Retail Pharmacy in Rochester, NY and a listed phone number of (585) 719-1932.
Profile Overview
- NPI
- 1619758968
- Provider Type
- Organization
- Primary Specialty
- Community/Retail Pharmacy
- Enumeration Date
- October 12, 2023
- Last Updated
- July 29, 2024
Practice Location
- 82 Holland St Ste 100
- Rochester, NY 14605-2131
Phone: (585) 719-1932
Mailing Address
- 214C Lake Ave
- Rochester, NY 14608-1208
Specialties
- Community/Retail Pharmacy (3336C0003X)
Full Record
- NPI
- 1619758968
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Anthony L. Jordan Health Corporation
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 214C Lake Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14608-1208
- Mailing Country
- US
- Mailing Phone
- (585) 784-5918
- Practice Street Address
- 82 Holland St Ste 100
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14605-2131
- Practice Country
- US
- Practice Phone
- (585) 719-1932
- Practice Fax
- (585) 719-1958
- Enumeration Date
- October 12, 2023
- Last Updated
- July 29, 2024
- Authorized Official Last Name
- Clark
- Authorized Official First Name
- Linda
- Authorized Official Middle Name
- L
- Authorized Official Title
- President/CEO
- Authorized Official Phone
- (585) 423-2870
- Organization Subpart
- Yes
- Parent Organization Name
- ANTHONY L. JORDAN HEALTH CORPORATION
- Parent Organization TIN
- <UNAVAIL>
- Authorized Official Name Prefix Text
- Dr.
- Authorized Official Credential Text
- MD
- Certification Date
- July 29, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Community/Retail Pharmacy (3336C0003X)
- Other Identifiers
- 040614 (NY, State License)