Provider Demographics
NPI:1720356264
Name:ROCHESTER ENTERPRISES INC
Entity Type:Organization
Organization Name:ROCHESTER ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:800-986-5164
Mailing Address - Street 1:2081 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 245
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1119
Mailing Address - Country:US
Mailing Address - Phone:800-986-5164
Mailing Address - Fax:800-986-5164
Practice Address - Street 1:2081 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 245
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1119
Practice Address - Country:US
Practice Address - Phone:800-986-5164
Practice Address - Fax:800-986-5164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0867846302F00000X, 332B00000X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336M0002XSuppliersPharmacyMail Order Pharmacy