Healthcare Provider Details

I. General information

NPI: 1356938500
Provider Name (Legal Business Name): ORLEANS COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 PARK AVE
MEDINA NY
14103-1078
US

IV. Provider business mailing address

200 OHIO ST
MEDINA NY
14103-1063
US

V. Phone/Fax

Practice location:
  • Phone: 585-798-2550
  • Fax:
Mailing address:
  • Phone: 585-798-8422
  • Fax: 585-798-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORI CONDO
Title or Position: ASSISTANT CONTROLLER
Credential:
Phone: 585-798-8422