Healthcare Provider Details

I. General information

NPI: 1003812330
Provider Name (Legal Business Name): GERRY HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 ROUTE 430
GREENHURST NY
14742-0400
US

IV. Provider business mailing address

PO BOX 365
GERRY NY
14740-0365
US

V. Phone/Fax

Practice location:
  • Phone: 716-483-5000
  • Fax: 716-488-2414
Mailing address:
  • Phone: 716-985-6812
  • Fax: 716-985-6607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0658301N
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LISA HAGLUND
Title or Position: CEO
Credential:
Phone: 716-483-5000