Provider Demographics
NPI:1164854451
Name:UNITED MEMORIAL MEDICAL CENTER
Entity Type:Organization
Organization Name:UNITED MEMORIAL MEDICAL CENTER
Other - Org Name:UNITED MEMORIAL MEDICAL CENTER OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHOELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-344-5495
Mailing Address - Street 1:127 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1631
Mailing Address - Country:US
Mailing Address - Phone:585-344-5263
Mailing Address - Fax:
Practice Address - Street 1:127 NORTH ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1631
Practice Address - Country:US
Practice Address - Phone:585-344-5263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED MEMORIAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-08
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy