Healthcare Provider Details

I. General information

NPI: 1609873520
Provider Name (Legal Business Name): ORLEANS COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OHIO ST
MEDINA NY
14103
US

IV. Provider business mailing address

200 OHIO ST
MEDINA NY
14103
US

V. Phone/Fax

Practice location:
  • Phone: 585-798-2000
  • Fax: 585-798-8444
Mailing address:
  • Phone: 585-798-2000
  • Fax: 585-798-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number3622700C
License Number StateNY

VIII. Authorized Official

Name: MARK SHURTZ
Title or Position: C.E.O.
Credential:
Phone: 585-798-8101