Healthcare Provider Details

I. General information

NPI: 1669405973
Provider Name (Legal Business Name): H C WATSON CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 DELAWARE AVE SUITE 400
BUFFALO NY
14202-1622
US

IV. Provider business mailing address

361 DELAWARE AVE SUITE 400
BUFFALO NY
14202-1622
US

V. Phone/Fax

Practice location:
  • Phone: 716-852-5900
  • Fax: 716-852-5913
Mailing address:
  • Phone: 716-852-5900
  • Fax: 716-852-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0124L001
License Number StateNY

VIII. Authorized Official

Name: MS. JUDITH C KETTEMAN
Title or Position: VICE PRESIDENT/AREA MANAGER
Credential:
Phone: 716-852-5900