Healthcare Provider Details

I. General information

NPI: 1689656852
Provider Name (Legal Business Name): CUBA MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W MAIN ST
CUBA NY
14727-1317
US

IV. Provider business mailing address

140 W MAIN ST
CUBA NY
14727-1317
US

V. Phone/Fax

Practice location:
  • Phone: 585-968-2000
  • Fax: 585-968-2635
Mailing address:
  • Phone: 585-968-2000
  • Fax: 585-968-2635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0226000N
License Number StateNY

VIII. Authorized Official

Name: NORMA KERLING
Title or Position: CEO
Credential:
Phone: 585-968-6751