Provider Demographics
NPI:1285804278
Name:BRUMMER, SANDRA M (PHARMD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:BRUMMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 BROOKS AVE
Mailing Address - Street 2:ATTN: PHARMACY OFFICE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3512
Mailing Address - Country:US
Mailing Address - Phone:585-239-2020
Mailing Address - Fax:585-239-2020
Practice Address - Street 1:3740 MCKINLEY PKWY
Practice Address - Street 2:ATTN: PHARMACY MANAGER
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219-2660
Practice Address - Country:US
Practice Address - Phone:716-824-8013
Practice Address - Fax:716-824-2372
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY049287OtherPHARMACIST LICENSE NUMBER