Healthcare Provider Details

I. General information

NPI: 1760576631
Provider Name (Legal Business Name): CHASE MEMORIAL NURSING HOME CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TERRACE HTS
NEW BERLIN NY
13411-9515
US

IV. Provider business mailing address

PO BOX 250 1 TERRACE HEIGHTS
NEW BERLIN NY
13411-0250
US

V. Phone/Fax

Practice location:
  • Phone: 607-847-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: KAREN ELLIOTT
Title or Position: CFO
Credential:
Phone: 607847702100