MEDICARE: ORCHARD MANOR INC.

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	314000000X	Skilled Nursing Facility	3622302N	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

General Provider Information

NPI Number	:	1134116858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORCHARD MANOR INC.

Provider Business Mailing Address
First Line	:	600 BATES RD
Second Line	:
City	:	MEDINA
State	:	NY
Zip	:	14103-9706
Country	:	US
Telephone Number	:	585-798-4100
Fax Number	:	585-798-5275

Provider Business Practice Location Address
First Line	:	600 BATES RD
Second Line	:
City	:	MEDINA
State	:	NY
Zip	:	14103-9706
Country	:	US
Telephone Number	:	585-798-4100
Fax Number	:	585-798-5275

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. THOMAS E. MORIEN
Credential	:
Telephone Number	:	585-798-4100

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	08/22/2020

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Directions to “ORCHARD MANOR INC. ” Practice Location

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