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General NPI Number Information
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NPI Number | 1689979478
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Entity Type | Organization
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Legal Business Name | WILLCARE BUFFALO,NY
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 78 HILLPINE RD
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City | CHEEKTOWAGA
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State | NY
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Zip | 14227-2258
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Country | US
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Telephone | 716-656-8909
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Fax |
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Provider Business Mailing Address
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Address Line | 78 HILLPINE RD
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City | CHEEKTOWAGA
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State | NY
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Zip | 14227-2258
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Country | US
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Telephone | 716-656-8909
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Fax |
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Authorized Official
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Title or Position | LPN HOME CARE
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Name | KATHLEEN GIBBONS
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Credential | LICENSED
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Telephone | 716-856-7500
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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 | 110402
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License Number State | NY
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