Healthcare Provider Details

I. General information

NPI: 1730171547
Provider Name (Legal Business Name): UR MEDICINE HOME CARE, CERTIFIED SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 EMPIRE BLVD
WEBSTER NY
14580-2029
US

IV. Provider business mailing address

2180 EMPIRE BLVD
WEBSTER NY
14580-2029
US

V. Phone/Fax

Practice location:
  • Phone: 585-787-2233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2701901L
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2701602
License Number StateNY

VIII. Authorized Official

Name: GREG T HUTTON
Title or Position: VP OF FINANCE
Credential:
Phone: 585-274-4225