Organization
PEACEANDGRACETRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLACE W FENNELL (OWNER)
(585) 284-5128
Entity
Organization
Contact information
Practice address
813 POND VIEW HTS, ROCHESTER, NY 14612-1350
(585) 284-5128
Mailing address
813 POND VIEW HTS, ROCHESTER, NY 14612-1350
(585) 284-5128
Taxonomy
Speciality
Code
Description
License number
State
261QM1103X
Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
292200000X
Dental Laboratory
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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