MEDICARE: TULLY HILL

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility

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	:	1629135512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TULLY HILL

Provider Business Mailing Address
First Line	:	PO BOX 1116
Second Line	:
City	:	TULLY
State	:	NY
Zip	:	13159-1116
Country	:	US
Telephone Number	:	315-696-6114
Fax Number	:	315-696-8509

Provider Business Practice Location Address
First Line	:	5821 ROUTE 80
Second Line	:
City	:	TULLY
State	:	NY
Zip	:	13159-1116
Country	:	US
Telephone Number	:	315-696-6114
Fax Number	:	315-696-8509

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MRS. STEPHANIE L VORMWALD
Credential	:	CPA
Telephone Number	:	315-696-6114

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	04/22/2014

Similar Medicare Providers

1114180510 — MARY ELIZABETH BEAN FNP
Practice Location Address:

5821 ROUTE 80 , BOX 1116
TULLY, NY
13159-1116

Practice Phone: 315-696-6114
Practice Fax: 315-696-8509

1457339756 — JAMES E EDINGER MD
Practice Location Address:

57 STATE ST
TULLY, NY
13159-3218

Practice Phone: 315-696-4635
Practice Fax: 315-696-6108

1386686376 — DR. JERRY RUSSELL BARTLESON M.D.
Practice Location Address:

7434 SONG LAKE RD
TULLY, NY
13159-9211

Practice Phone: 315-696-5539
Practice Fax: 315-696-5539

1588607352 — TOWN OF TULLY
Practice Location Address:

1 RAILROAD ST
TULLY, NY
13159-3245

Practice Phone: 315-696-6414
Practice Fax: 315-696-8396

1992812176 — KPH HEALTHCARE SERVICES, INC.
Practice Location Address:

596 ROUTE 11
TULLY, NY
13159

Practice Phone: 315-696-8796
Practice Fax: 315-696-6145

1386752442 — MRS. CHERYL K KARPINSKI LCSWR
Practice Location Address:

426 LONG RD
TULLY, NY
13159-9430

Practice Phone: 315-727-8855
Practice Fax: 315-696-8251

Directions to “TULLY HILL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.