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General NPI Number Information
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NPI Number | 1962786780
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Entity Type | Organization
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Legal Business Name | SUSQUEHANNA HOME HEALTH CARE AGENCY
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 270 RIVERSIDE DR
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2739
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Country | US
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Telephone | 607-729-9206
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Fax |
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Provider Business Mailing Address
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Address Line | 282 RIVERSIDE DR
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2727
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Country | US
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Telephone | 607-729-9206
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Fax | 607-797-3229
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Authorized Official
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Title or Position | CONTROLL
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Name | BERNADETTE A BRINSKO
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Credential |
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Telephone | 607-729-9206
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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 | 1305L001
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License Number State | NY
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