Provider Demographics
NPI:1891313326
Name:ROCHESTER COMMUNITY PHARMACY LLC
Entity Type:Organization
Organization Name:ROCHESTER COMMUNITY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWASEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:FASEEMO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:612-808-9280
Mailing Address - Street 1:1604 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0318
Mailing Address - Country:US
Mailing Address - Phone:612-808-9280
Mailing Address - Fax:
Practice Address - Street 1:1604 1ST ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0318
Practice Address - Country:US
Practice Address - Phone:612-808-9280
Practice Address - Fax:507-888-3064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCHESTER COMMUNITY PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy