# MODEN GIROUX INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Middleport Family Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376109850
- **Authorized official:** STEPHEN L. GIROUX RPH (PRESIDENT AND CEO)
- **Authorized official phone:** (716) 735-3261

## Contact information

- **Practice address:** 81 TELEGRAPH RD, MIDDLEPORT, NY 14105-9638
- **Practice address phone:** (716) 735-3261
- **Practice address fax:** (716) 735-3351
- **Mailing address:** PO BOX 188, MIDDLEPORT, NY 14105-0188
- **Mailing address phone:** (716) 735-3261
- **Mailing address fax:** (716) 735-3351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/10/2019
- **Last updated:** 05/10/2019