MEDICARE: OSWEGO HEALTH HOME CARE LLC..

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	3701600	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	:	1285639625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSWEGO HEALTH HOME CARE LLC..

Provider Business Mailing Address
First Line	:	510 S 4TH ST
Second Line	:
City	:	FULTON
State	:	NY
Zip	:	13069-2951
Country	:	US
Telephone Number	:	315-598-1544
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 S 4TH ST
Second Line	:
City	:	FULTON
State	:	NY
Zip	:	13069-2951
Country	:	US
Telephone Number	:	315-598-1544
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ERIC T CAMPBELL
Credential	:
Telephone Number	:	315-349-5531

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	04/12/2024

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