MEDICARE: WILLCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1173161	NY

General Provider Information

NPI Number	:	1629393079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLCARE

Provider Business Mailing Address
First Line	:	4315 RIDGE RD
Second Line	:
City	:	ELBA
State	:	NY
Zip	:	14058-9763
Country	:	US
Telephone Number	:	585-757-2780
Fax Number	:

Provider Business Practice Location Address
First Line	:	4315 RIDGE RD
Second Line	:
City	:	ELBA
State	:	NY
Zip	:	14058-9763
Country	:	US
Telephone Number	:	585-757-2780
Fax Number	:

Authorized Official
Title or Position	:	RN
Name	:	GERTRUDE SCHAD
Credential	:
Telephone Number	:	585-757-2780

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	03/29/2010

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Directions to “WILLCARE ” Practice Location

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