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4 Montgomery Hts Waddington NY 13694-7712 | |
(315) 388-7872 | |
(315) 713-6511 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4 Montgomery Hts, Waddington, New York |
Authorized Official Name and Position | Morgan L Pierce (VP OF FINANCE) |
Authorized Official Contact | 3155195725 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1001 West St Carthage NY 13619-9703 Ph: (315) 519-5724 | 4 Montgomery Hts Waddington NY 13694-7712 Ph: (315) 388-7872 |
NPI Number | 1871365072 |
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Provider Enumeration Date | 10/23/2023 |
Last Update Date | 10/28/2023 |
Medicare PECOS PAC ID | 9931010485 |
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Medicare Enrollment ID | O20231228000748 |
Identifier | Type | State | Issuer |
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1871365072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |