Healthcare Provider Details

I. General information

NPI: 1902730575
Provider Name (Legal Business Name): SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N UNION ST
OLEAN NY
14760-2736
US

IV. Provider business mailing address

135 N UNION ST
OLEAN NY
14760-2736
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERIC B. BLAKE
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 740-454-2086