Organization
ANTHONY L. JORDAN HEALTH CORPORATION
Active
Parent organization
ANTHONY L. JORDAN HEALTH CORP
Other names
JORDAN HEALTH LINK
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANTHONY L. JORDAN HEALTH CORP
Authorized official
JANICE HARBIN DDS (PRESIDENT/CEO)
(585) 423-5800
Entity
Organization
Contact information
Practice address
273 UPPER FALLS BLVD, ROCHESTER, NY 14605-2103
(585) 784-5900
Mailing address
82 HOLLAND ST, ROCHESTER, NY 14605-2131
(585) 423-5800
(585) 423-2806
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2701211R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00384969
—
NY
01
—
16467A
MEDICARE PART B
NY
01
—
331838
MEDICARE PART A
NY
01
—
6613
BLUE CROSS OF ROCHESTER
NY
01
—
G0187295590
BLUE CHOICE OF ROCHESTER
NY
Enumeration date
11/05/2010
Last updated
06/28/2016
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