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NPI Code Detail

MEDICARE: GERRY HOMES INC

MEDICARE: GERRY HOMES 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
1314000000XSkilled Nursing Facility0602310NNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100030010001OTHERNYSENIOR CHOICE PROVIDER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366448706
Entity Type Code : Organization
Provider Name (Legal Business Name) : GERRY HOMES INC
Provider Business Mailing Address
First Line : PO BOX 360
Second Line :
City : GERRY
State : NY
Zip : 14740-0360
Country : US
Telephone Number : 716-985-6813
Fax Number : 716-985-6607
Provider Business Practice Location Address
First Line : 150 PRATHER AVE
Second Line :
City : JAMESTOWN
State : NY
Zip : 14701-6710
Country : US
Telephone Number : 716-488-1921
Fax Number : 716-484-2933
Authorized Official
Title or Position : CEO
Name : LISA HAGLUND
Credential :
Telephone Number : 716-488-1921
Provider Enumeration Date : 06/21/2005
Last Update Date : 12/05/2025

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