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NPI Code Detail

MEDICARE: BROOKS - TLC HOSPITAL SYSTEM, INC.

MEDICARE: BROOKS - TLC HOSPITAL SYSTEM, 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
1282N00000XGeneral Acute Care Hospital0601000HNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1040401000245OTHERNYFIDELIS
20001400701OTHERNYUNIVERA
36000760OTHERNYBLUE CROSS WNY
4H33OTHERNYINDEPENDENT HEALTH
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215917224
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKS - TLC HOSPITAL SYSTEM, INC.
Provider Business Mailing Address
First Line : 529 CENTRAL AVE
Second Line :
City : DUNKIRK
State : NY
Zip : 14048-2514
Country : US
Telephone Number : 716-375-6490
Fax Number : 716-363-7228
Provider Business Practice Location Address
First Line : 529 CENTRAL AVE
Second Line :
City : DUNKIRK
State : NY
Zip : 14048-2514
Country : US
Telephone Number : 716-375-6490
Fax Number : 716-363-7228
Authorized Official
Title or Position : CEO
Name : KEN MORRIS
Credential :
Telephone Number : 716-363-7260
Provider Enumeration Date : 01/18/2006
Last Update Date : 02/09/2024

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