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General NPI Number Information
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NPI Number | 1063562841
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Entity Type | Organization
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Legal Business Name | TIOGA COUNTY
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 1062 STATE RTE. 38
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City | OWEGO
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State | NY
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Zip | 13827-3209
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Country | US
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Telephone | 607-687-8573
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Fax | 607-223-7063
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Provider Business Mailing Address
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Address Line | 1062 STATE RTE. 38 P. O. BOX 120
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City | OWEGO
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State | NY
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Zip | 13827-3209
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Country | US
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Telephone | 607-687-8604
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Fax | 607-223-7034
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE SERVICES
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Name | MR. DENIS MCCANN
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Credential |
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Telephone | 607-687-8604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5320901L
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License Number State | NY
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