Healthcare Provider Details

I. General information

NPI: 1033697875
Provider Name (Legal Business Name): CAREGIVER CONCIERGE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 WENDE ST LOWR
BUFFALO NY
14211-1728
US

IV. Provider business mailing address

PO BOX 1145
CHEEKTOWAGA NY
14225-8145
US

V. Phone/Fax

Practice location:
  • Phone: 716-427-8843
  • Fax:
Mailing address:
  • Phone: 716-427-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: FANTAH WHITT
Title or Position: FOUNDER
Credential:
Phone: 716-427-8843