Healthcare Provider Details

I. General information

NPI: 1720171572
Provider Name (Legal Business Name): GENESEE REGION HOME CARE OF ONTARIO COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 WINTON RD S
ROCHESTER NY
14623-2905
US

IV. Provider business mailing address

3111 WINTON RD S
ROCHESTER NY
14623-2905
US

V. Phone/Fax

Practice location:
  • Phone: 585-214-1000
  • Fax: 585-214-1136
Mailing address:
  • Phone: 585-214-1000
  • Fax: 585-214-1136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0811L002
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number0811L002
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number0811L001
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0811L001
License Number StateNY

VIII. Authorized Official

Name: MS. JEANNE CHIRICO
Title or Position: ADMINISTRATOR
Credential:
Phone: 585-214-1219