NPIMap

Organization Active NPI

Genesee Valley Group Health Association

Doing business as Lifetime Health Medical Group

  • Clinic Pharmacy
  • Rochester, NY
National Provider Identifier
1497811939
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
017164 Issued in NY
Legal business name
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Doing business as
Lifetime Health Medical Group
Practice address
1850 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2532
Phone
(585) 292-8488
Fax
(585) 292-6598
NPI assigned
Dec 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Tiffany Katherine Pepe, RPH
Title
Supervising Pharmacist
Phone
(585) 292-8488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 017164 NY Primary

Addresses

Primary practice location

1850 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2532

Mailing address

1850 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2532
Phone (585) 292-8488

Other identifiers 1

IdentifierTypeStateIssuer
01853745MedicaidNY

Other names 1

  • Lifetime Health Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Genesee Valley Group Health Associaton52 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497811939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BRIGHTON HENRIETTA TOWN LINE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232532",
            "telephone_number": "585-292-8488",
            "fax_number": "585-292-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BRIGHTON HENRIETTA TOWN LINE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232532",
            "telephone_number": "585-292-8488",
            "fax_number": "585-292-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VALLEY GROUP HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEPE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "585-292-8488",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NY",
            "license": "017164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01853745",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.