Healthcare Provider Details

I. General information

NPI: 1972053320
Provider Name (Legal Business Name): TOWN OF WEBSTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 04/23/2024
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 JACKSON ROAD
WEBSTER NY
14580-8705
US

IV. Provider business mailing address

8610 MAIN STREET
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 585-787-9060
  • Fax:
Mailing address:
  • Phone: 716-204-3350
  • Fax: 716-247-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number6260
License Number StateNY

VIII. Authorized Official

Name: THOMAS J FLAHERTY
Title or Position: TOWN SUPERVISOR
Credential:
Phone: 585-872-7070