| Jericho Road Community Health Center | |
|
1021 Broadway St Buffalo NY 14212-1460 | |
| (716) 529-3020 | |
| (716) 529-3040 |
| Full Name | Jericho Road Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1021 Broadway St, Buffalo, New York |
| Authorized Official Name and Position | Jackie Endress (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7163483000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jericho Road Community Health Center 184 Barton St Buffalo NY 14213-1573 Ph: (716) 881-6191 | Jericho Road Community Health Center 1021 Broadway St Buffalo NY 14212-1460 Ph: (716) 529-3020 |
| NPI Number | 1952893091 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 08/23/2021 |
| Medicare PECOS PAC ID | 5597992933 |
|---|---|
| Medicare Enrollment ID | O20181023002193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952893091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 1401237R (New York) | Primary |
Buffalo Medical Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 Genesee St, Buffalo, NY 14211 Phone: 716-895-2200 Fax: 716-895-3300 | |
Jeremiah O Sullivan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2218 Main St, Buffalo, NY 14214 Phone: 716-834-4141 Fax: 716-838-5840 | |
Greater Buffalo United Accountable Healthcare Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 564 Niagara St, Buffalo, NY 14201 Phone: 716-882-0366 Fax: 716-830-4840 | |
Buffalo Psychiatric Center Act Team Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Forest Ave, Building 51 A Area, Buffalo, NY 14213 Phone: 716-885-2261 | |
Winston G Douglas Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 755 Wehrle Dr, Buffalo, NY 14225 Phone: 716-884-8033 Fax: 716-342-2523 | |
Carewell Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 462 Grider St, Buffalo, NY 14215 Phone: 716-830-5453 Fax: 716-332-3525 | |
Nutrition With Noelle P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2075 Sheridan Dr, Buffalo, NY 14223 Phone: 716-417-6388 |