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Organization

ANTHONY L. JORDAN HEALTH CORPORATION

Active
Parent organization
ANTHONY L. JORDAN HEALTH CORPORATION
Other names
Jordan Health at Community Place
Organization subpart
Yes

Provider details

NPI number
Legal business name
ANTHONY L. JORDAN HEALTH CORPORATION
Authorized official
JANICE HARBIN DDS (PRESIDENT/CEO)
(585) 423-5800
Entity
Organization

Contact information

Practice address
151 PARSELLS AVE, JORDAN HEALTH AT COMMUNITY PLACE, ROCHESTER, NY 14609
(585) 454-7530
Mailing address
82 HOLLAND ST, ALJHC, ROCHESTER, NY 14605-2131
(585) 423-5800
(585) 423-2890

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04065629
NY
01
16467A
MEDICARE PART B PTAN
NY
01
331838
MEDICARE PART A PTAN
NY
Enumeration date
09/06/2012
Last updated
10/08/2015
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