Provider Demographics
NPI:1962637330
Name:WEGMANS FOOD MARKETS, INC.
Entity Type:Organization
Organization Name:WEGMANS FOOD MARKETS, INC.
Other - Org Name:WEGMANS PHARMACY #041
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-429-3902
Mailing Address - Street 1:1500 BROOKS AVE
Mailing Address - Street 2:ATTN: PHARMACY OFFICE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624
Mailing Address - Country:US
Mailing Address - Phone:585-239-2009
Mailing Address - Fax:585-239-2044
Practice Address - Street 1:2281 CARL D SILVER PKWY
Practice Address - Street 2:ATTN: PHARMACY MANAGER
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4983
Practice Address - Country:US
Practice Address - Phone:540-322-4845
Practice Address - Fax:540-322-4898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEGMANS FOOD MARKETS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-28
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
VA0201004291333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201004291OtherPHARMACY LICENSE
VA48-41640OtherNCPDP NUMBER
VAFW-1400821OtherDEA NUMBER
VA0639890076Medicare NSC