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) 324-3750.

NPI 1750700399Rochester, NYFederally Qualified Health Center (FQHC)

Profile Overview

NPI
1750700399
Provider Type
Organization
Primary Specialty
Federally Qualified Health Center (FQHC)
Enumeration Date
April 10, 2014
Last Updated
July 16, 2014

Practice Location

  • 950 Norton St
  • Rochester, NY 14621-3732

Phone: (585) 324-3750

Mailing Address

  • 82 Holland St
  • Attn: Hr
  • Rochester, NY 14605-2131

Specialties

  • Federally Qualified Health Center (FQHC) (261QF0400X)
Full Record
NPI
1750700399
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
82 Holland St
Mailing Address Line 2
Attn: Hr
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14605-2131
Mailing Country
US
Mailing Phone
(585) 423-2816
Practice Street Address
950 Norton St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3732
Practice Country
US
Practice Phone
(585) 324-3750
Enumeration Date
April 10, 2014
Last Updated
July 16, 2014
Authorized Official Last Name
Graham
Authorized Official First Name
Monica
Authorized Official Title
Credentialing
Authorized Official Phone
(585) 423-2816
Organization Subpart
Yes
Parent Organization Name
ANTHONY L. JORDAN HEALTH CORPORATION
Parent Organization TIN
<UNAVAIL>
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Federally Qualified Health Center (FQHC) (261QF0400X)