Provider Demographics
NPI:1609862143
Name:MEDICAN GROUP LLC
Entity Type:Organization
Organization Name:MEDICAN GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, CGP
Authorized Official - Phone:716-692-2020
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-0008
Mailing Address - Country:US
Mailing Address - Phone:716-692-2020
Mailing Address - Fax:716-692-5565
Practice Address - Street 1:7229 ERICA LN
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-4900
Practice Address - Country:US
Practice Address - Phone:716-692-2020
Practice Address - Fax:716-692-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0328321835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty