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ANTHONY L. JORDAN HEALTH CORPORATION NPI 1013291335


NPI Information

NPI: 1013291335
Provider Name: ANTHONY L. JORDAN HEALTH CORPORATION

Doing Business As: BROWN SQUARE CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
322 LAKE AVE
BROWN SQUARE CENTER
ROCHESTER, NY
ZIP 14608
Phone: (585) 254-6480
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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 1013291335. The provider is registered as an organization entity type.
The provider Is Doing Business As Brown Square Center.

The provider's business location address is:

322 LAKE AVE
BROWN SQUARE CENTER
ROCHESTER, NY
ZIP 14608-162
Phone: (585) 254-6480
Fax: (585) 254-1092

The provider's authorized official is Janice Harbin .
The authorized official title is President/ceo and has the following contact phone number (585) 423-5800.

The enumeration date for this NPI number is 10/5/2011 and was last updated on 10/8/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)2701211RNEW YORKYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
116467AOTHERNEW YORKMEDICARE PART B
203800906MEDICAIDNEW YORK
3331838OTHERNEW YORKMEDICARE PART A
46613OTHERNEW YORKBLUE CROSS OF ROCHESTER
5G0187295590OTHERNEW YORKBLUE CHOICE OF ROCHESTER

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: 11/14/2023

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