Provider Demographics
NPI:1326820630
Name:MODEN-GIROUX INC
Entity Type:Organization
Organization Name:MODEN-GIROUX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIROUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-260-1131
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:MIDDLEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14105-0188
Mailing Address - Country:US
Mailing Address - Phone:716-735-3261
Mailing Address - Fax:716-735-3351
Practice Address - Street 1:6344 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1095
Practice Address - Country:US
Practice Address - Phone:716-683-9444
Practice Address - Fax:716-683-9425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy