1700944998 NPI number — PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700944998 NPI number — PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.
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:
Provider Other Organization Name Type Code:
6
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:
1700944998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1219 N FOREST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-3230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-634-8132
Provider Business Mailing Address Fax Number:
716-817-2509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
692 MILLERSPORT HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14226-2401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-874-5600
Provider Business Practice Location Address Fax Number:
716-566-4988
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILKINS
Authorized Official First Name:
JACOB
Authorized Official Middle Name:
TROY
Authorized Official Title or Position:
ADMINISTRATOR/VICE PRESIDENT
Authorized Official Telephone Number:
716-874-5600

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1451602 , 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: 01415654 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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