| Organization Name: | FILLMORE FISHER PHARMACY INC |
| NPI Number: | 1598754327 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN S. LOUCKS (PRESIDENT) |
| Mailing Address: | 2 Center Street Cuba |
| State: | NY US |
| Postal Code: | 14727 |
| Phone Number: | 5859683111 |
| Fax Number: | 5859687998 |
| NPI Enumeration Date: | 10/14/2005 |
| NPI Last Update Date: | 11/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 020318 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |