ANTHONY L. JORDAN HEALTH CORPORATION NPI 1437424231

NPI Information

NPI: 1437424231
Provider Name: ANTHONY L. JORDAN HEALTH CORPORATION

Doing Business As: GLENWOOD GARDENS

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
41 KESTREL ST
ROCHESTER, NY
ZIP 14613
Phone: (585) 697-7130
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ANTHONY L. JORDAN HEALTH CORPORATION is a federally qualified health center (fqhc) clinic center in Rochester, NY. ANTHONY L. JORDAN HEALTH CORPORATION NPI is 1437424231. The provider is registered as an organization entity type.
The provider Is Doing Business As Glenwood Gardens.

The provider's business location address is:

41 KESTREL ST
ROCHESTER, NY
ZIP 14613-120
Phone: (585) 697-7130
Fax: (585) 697-7131

The provider's authorized official is Bridgette Wiefling .
The authorized official title is President/ceo and has the following contact phone number (585) 423-2878.

The enumeration date for this NPI number is 3/13/2012 and was last updated on 3/19/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	2701211R	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	16467A	OTHER	NEW YORK	MEDICARE PART B
2	331838	OTHER	NEW YORK	MEDICARE PART A
3	6613	OTHER	NEW YORK	BLUE CROSS OF ROCHESTER
4	G0187295590	OTHER	NEW YORK	BLUE CHOICE OF ROCHESTER
5	00384969	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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