Organization
MODEN GIROUX INC
Active
Other names
d/b/a Middleport Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GIROUX RPH (PRESIDENT)
(716) 735-3261
Entity
Organization
Contact information
Practice address
81 ROCHESTER RD, MIDDLEPORT, NY 14105-9638
(716) 735-3261
(716) 735-3351
Mailing address
PO BOX 188, MIDDLEPORT, NY 14105-0188
(716) 735-3261
(716) 735-3351
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
017837
NY
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00775966
—
NY
01
—
2061795
PK
—
Enumeration date
10/11/2006
Last updated
02/28/2017
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