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NPI Code Detail

MEDICARE: OAK ORCHARD COMMUNITY HEALTH CENTER INC.

MEDICARE: OAK ORCHARD COMMUNITY HEALTH CENTER 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
1261QC1500XCommunity Health Clinic/Center2701221RNY
2261QM1000XMigrant Health Clinic/Center2701221RNY
3261QF0400XFederally Qualified Health Center (FQHC)2701221RNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1704524OTHERNYEXCELLUS BS GROUP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598707812
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAK ORCHARD COMMUNITY HEALTH CENTER INC.
Provider Business Mailing Address
First Line : 300 WEST AVE
Second Line :
City : BROCKPORT
State : NY
Zip : 14420-1118
Country : US
Telephone Number : 585-637-3905
Fax Number : 585-637-4990
Provider Business Practice Location Address
First Line : 300 WEST AVE
Second Line :
City : BROCKPORT
State : NY
Zip : 14420-1118
Country : US
Telephone Number : 585-637-3905
Fax Number : 585-637-4990
Authorized Official
Title or Position : CEO
Name : KAREN KINTER
Credential :
Telephone Number : 585-637-3905
Provider Enumeration Date : 06/12/2006
Last Update Date : 05/11/2023

Similar Medicare Providers

1619822657 — MELISSA FEOLA
Practice Location Address:
300 WEST AVE
BROCKPORT, NY
14420-1118
Practice Phone: 585-637-3905
Practice Fax:
1740248277 — DR. YVONNE M WILLIAMS OD
Practice Location Address:
300 WEST AVE , OAK ORCHARD COMMUNITY HEALTH CENTER
BROCKPORT, NY
14420-1118
Practice Phone: 585-637-0240
Practice Fax: 585-637-0947
1568406015 — DR. DAVID IRWIN SMITH M.D.
Practice Location Address:
300 WEST AVE
BROCKPORT, NY
14420-1118
Practice Phone: 585-637-3905
Practice Fax: 585-637-4990
1144264656 — MARA LYNNE TROJANSKI RD,CDN
Practice Location Address:
300 WEST AVE
BROCKPORT, NY
14420-1118
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Practice Fax: 585-637-4990
1336183318 — DR. JAMES PETER GOETZ M.D.
Practice Location Address:
300 WEST AVE
BROCKPORT, NY
14420-1118
Practice Phone: 585-637-3905
Practice Fax: 585-637-4990
1629014410 — CATHERINE ANN BURKE CNM
Practice Location Address:
300 WEST AVE
BROCKPORT, NY
14420-1118
Practice Phone: 585-637-3905
Practice Fax: 585-637-4990

Directions to “OAK ORCHARD COMMUNITY HEALTH CENTER INC. ” Practice Location

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