Provider Demographics
NPI:1275000671
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-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:OLUWASEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:FASEEMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-721-5859
Mailing Address - Street 1:3916 ORCHARDVIEW LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-4326
Mailing Address - Country:US
Mailing Address - Phone:313-721-5859
Mailing Address - Fax:
Practice Address - Street 1:314 ELTON HILLS DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2476
Practice Address - Country:US
Practice Address - Phone:507-322-6124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy