Organization
CRM-CANANDAIGUA LLC
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF HETRICK (C.O.O.)
(585) 337-4300
Entity
Organization
Contact information
Practice address
75 VICTOR HEIGHTS PKWY STE C, VICTOR, NY 14564-8926
(585) 337-4300
(585) 396-7264
Mailing address
75 VICTOR HEIGHTS PKWY STE C, VICTOR, NY 14564-8926
(585) 337-4300
(585) 396-7264
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03467627
—
NY
Enumeration date
02/12/2020
Last updated
01/27/2021
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