Healthcare Provider Details

I. General information

NPI: 1164347167
Provider Name (Legal Business Name): RICH INDEPENDENT SERVICE COORDINATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 VERNON PL
BUFFALO NY
14214-2013
US

IV. Provider business mailing address

83 VERNON PL
BUFFALO NY
14214-2013
US

V. Phone/Fax

Practice location:
  • Phone: 716-579-9394
  • Fax: 716-641-0661
Mailing address:
  • Phone: 716-579-9394
  • Fax: 716-641-0661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MS. DENEE RICH
Title or Position: PRESIDENT/CEO/SERVICE COORDINATOR
Credential:
Phone: 716-579-9394