Organization
PAUL R GROUT
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL R GROUT RPH (OWNER)
(585) 798-1212
Entity
Organization
Contact information
Practice address
142 E CENTER ST, MEDINA, NY 14103-1621
(585) 798-1212
(585) 798-2041
Mailing address
142 E CENTER ST, MEDINA, NY 14103-1621
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
022120
NY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00610586
—
NY
01
—
3335951
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/02/2007
Last updated
03/07/2023
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