1205834801 NPI number — ONTARIO COUNTY COUNTY TREAS

Table of content: (NPI 1205834801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205834801 NPI number — ONTARIO COUNTY COUNTY TREAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONTARIO COUNTY COUNTY TREAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ONTARIO COUNTY HOME HEALTH AGENCY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205834801
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3019 COUNTY COMPLEX DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANANDAIGUA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14424-9505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-396-4997
Provider Business Mailing Address Fax Number:
585-396-4313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3019 COUNTY COMPLEX DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANANDAIGUA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14424-9505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-396-4997
Provider Business Practice Location Address Fax Number:
585-396-4313
Provider Enumeration Date:
07/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BEER
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
585-394-4354

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  3429600 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103317CI . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P010103735 . This is a "EXCELLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00355853 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com