Healthcare Provider Details

I. General information

NPI: 1003926551
Provider Name (Legal Business Name): CH HOME CARE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 N UNION ST
OLEAN NY
14760-2705
US

IV. Provider business mailing address

213 N UNION ST
OLEAN NY
14760-2705
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-6666
  • Fax: 716-373-6671
Mailing address:
  • Phone: 716-373-6666
  • Fax: 716-373-6671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier000551015001
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerBCBS
# 2
Identifier00621581
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MR. DALE E CARLSON
Title or Position: CEO RESP TEC
Credential:
Phone: 716-373-6666