Provider Demographics
NPI:1164546412
Name:FARIS, GEORGE JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:JOSEPH
Last Name:FARIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 LATTA ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612
Mailing Address - Country:US
Mailing Address - Phone:585-663-6950
Mailing Address - Fax:585-663-5248
Practice Address - Street 1:2050 LATTA ROAD
Practice Address - Street 2:FARIS PHARMACY INC
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612
Practice Address - Country:US
Practice Address - Phone:585-663-6950
Practice Address - Fax:585-663-5248
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0262301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist