Healthcare Provider Details

I. General information

NPI: 1689873721
Provider Name (Legal Business Name): AMAK HEALTH CARE AGENCY,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3258 MAIN ST
BUFFALO NY
14214-1334
US

IV. Provider business mailing address

3258 MAIN ST
BUFFALO NY
14214-1334
US

V. Phone/Fax

Practice location:
  • Phone: 716-832-0875
  • Fax: 716-832-4836
Mailing address:
  • Phone: 716-832-0875
  • Fax: 716-832-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01141753
Identifier TypeMEDICAID
Identifier StateNY
Identifier IssuerSKILLED NURSING

VIII. Authorized Official

Name: NKECHINYERE ORIAKU
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 716-832-0875