MEDICARE: JEFFERSON COUNTY PUBLIC HEALTH SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	2201600	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043213283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFERSON COUNTY PUBLIC HEALTH SERVICE

Provider Business Mailing Address
First Line	:	531 MEADE ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-1225
Country	:	US
Telephone Number	:	315-786-3770
Fax Number	:	315-786-3761

Provider Business Practice Location Address
First Line	:	531 MEADE ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-1225
Country	:	US
Telephone Number	:	315-786-3770
Fax Number	:	315-786-3761

Authorized Official
Title or Position	:	PUBLIC HEALTH DIRECTOR
Name	:	MR. STEPHEN A JENNINGS
Credential	:
Telephone Number	:	315-786-3715

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/08/2025

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Directions to “JEFFERSON COUNTY PUBLIC HEALTH SERVICE ” Practice Location

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