Provider Demographics
NPI:1598476269
Name:UNIVERSITY OF ROCHESTER
Entity Type:Organization
Organization Name:UNIVERSITY OF ROCHESTER
Other - Org Name:STRONG MEMORIAL HOSPITAL-UNIVERSITY OF ROCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, AMBULATORY PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:585-275-9688
Mailing Address - Street 1:120 CORPORATE WOODS STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1455
Mailing Address - Country:US
Mailing Address - Phone:585-756-4016
Mailing Address - Fax:585-272-1062
Practice Address - Street 1:10 MIRACLE MILE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5851
Practice Address - Country:US
Practice Address - Phone:585-602-4350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039862OtherNYS PHARMACY LICENSE