Organization Name: | FILLMORE FISHER PHARMACY INC |
NPI Number: | 1851380679 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN S LOUCKS (OWNER/PHARMACIST) |
Mailing Address: | 138 N Main St Wellsville |
State: | NY US |
Postal Code: | 148951151 |
Phone Number: | 5855932611 |
Fax Number: | 5855931903 |
NPI Enumeration Date: | 10/14/2005 |
NPI Last Update Date: | 11/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 014331 |
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 |