=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689039489
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OSWEGO COUNTY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2015
-----------------------------------------------------
Last Update Date | 11/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 70 BUNNER ST
-----------------------------------------------------
City | OSWEGO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13126-3357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-349-3547
-----------------------------------------------------
Fax | 315-349-8431
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 70 BUNNER ST
-----------------------------------------------------
City | OSWEGO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13126-3357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-349-3547
-----------------------------------------------------
Fax | 315-349-8431
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PUBLIC HEALTH
-----------------------------------------------------
Name | VERA DUNSMOOR
-----------------------------------------------------
Credential | MSNE, RN
-----------------------------------------------------
Telephone | 315-532-7082
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 2594L001
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------