MEDICARE: ARBOR PARK HEALTH CARE 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
1	314000000X	Skilled Nursing Facility	1461301N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00011438901	OTHER	NY	UNIVERA
2	000000225000	OTHER	NY	BLUE CROSS & BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1V	OTHER	NY	INDEPENDENT HEALTH

General Provider Information

NPI Number	:	1932146933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARBOR PARK HEALTH CARE CENTER, INC

Provider Business Mailing Address
First Line	:	300 GLEED AVE
Second Line	:	CO THE PARK ASSOCIATES, INC.
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2980
Country	:	US
Telephone Number	:	716-652-2820
Fax Number	:	716-655-2320

Provider Business Practice Location Address
First Line	:	2806 GEORGE ST
Second Line	:
City	:	EDEN
State	:	NY
Zip	:	14057-1205
Country	:	US
Telephone Number	:	716-992-3987
Fax Number	:	716-992-2281

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. JOHN SMITH
Credential	:
Telephone Number	:	716-805-1474

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/19/2008

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