MEDICARE: ERIE COUNTY OFFICE OF AUDITOR

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1912715897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIE COUNTY OFFICE OF AUDITOR

Provider Business Mailing Address
First Line	:	420 SUPERIOR ST
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-1849
Country	:	US
Telephone Number	:	419-626-5623
Fax Number	:

Provider Business Practice Location Address
First Line	:	4501 VENICE HEIGHTS BLVD RM 17
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-1630
Country	:	US
Telephone Number	:	419-626-5623
Fax Number	:

Authorized Official
Title or Position	:	CFO/CEO
Name	:	JOSEPH PALMUCCI
Credential	:
Telephone Number	:	419-626-5623

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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Directions to “ERIE COUNTY OFFICE OF AUDITOR ” Practice Location

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