Healthcare Provider Details

I. General information

NPI: 1407899743
Provider Name (Legal Business Name): WY CNTY COMM HOSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/21/2016
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

400 N MAIN ST
WARSAW NY
14569-1025
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-8940
  • Fax: 585-786-1240
Mailing address:
  • Phone: 585-786-8940
  • Fax: 585-786-1240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number006545
License Number StateNY

VIII. Authorized Official

Name: CHARLES BUROMETTO
Title or Position: SR PHCIST
Credential: RPH
Phone: 585-786-8940