Healthcare Provider Details

I. General information

NPI: 1104972389
Provider Name (Legal Business Name): WYOMING COUNTY COMMUNITYHEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N MAIN ST
WARSAW NY
14569-1025
US

IV. Provider business mailing address

299 BARNSDALE AVE
WEST SENECA NY
14224-1182
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-2233
  • Fax:
Mailing address:
  • Phone: 716-624-0602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number004070-1
License Number StateNY

VIII. Authorized Official

Name: MELISSA CLAIRE APRILE
Title or Position: CERTIFIED OCCUPATIOAL THERAPY ASSIS
Credential:
Phone: 585-786-2233