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5877 Old State Route 19 Belmont NY 14813 | |
(585) 268-5700 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 5877 Old State Route 19, Belmont, New York |
Authorized Official Name and Position | Casey Lathers (PFS SUPERVISOR) |
Authorized Official Contact | 5855962052 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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191 N Main St Wellsville NY 14895-1150 Ph: () - | 5877 Old State Route 19 Belmont NY 14813 Ph: (585) 268-5700 |
NPI Number | 1376166538 |
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Provider Enumeration Date | 05/22/2020 |
Last Update Date | 03/10/2021 |
Medicare PECOS PAC ID | 7012828486 |
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Medicare Enrollment ID | O20190924000124 |
Identifier | Type | State | Issuer |
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1376166538 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |