Healthcare Provider Details

I. General information

NPI: 1336183805
Provider Name (Legal Business Name): COUNTY OF CATTARAUGUS COUNTY TREASURER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LEO MOSS DR SUITE 4010
OLEAN NY
14760-1100
US

IV. Provider business mailing address

1 LEO MOSS DR SUITE 4010
OLEAN NY
14760-1100
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-8050
  • Fax: 716-701-3737
Mailing address:
  • Phone: 716-373-8050
  • Fax: 716-701-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0401600 & 0401901L
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier527
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerBC/BS AND CB
# 2
Identifier00475049
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 3
Identifier8390018
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerIH & ENCOMPASS 65
# 4
Identifier00660595
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 5
Identifier00011208901
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerUNIVERA & SR. CHOICE

VIII. Authorized Official

Name: DR. KEVIN D WATKINS
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: MD, MPH
Phone: 716-701-3398