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Organization
HERITAGE VILLAGE REHAB AND SKILLED NURSING INC
Active
Organization
HERITAGE VILLAGE REHAB AND SKILLED NURSING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BOSWELL (VICE PRESIDENT OF FINANCE)
(716) 338-9766
Entity
Organization
Contact information
Practice address
4600 ROUTE 60, GERRY, NY 14740-9562
(716) 985-4649
(716) 985-6638
Mailing address
4600 ROUTE 60, GERRY, NY 14740-9562
(716) 985-4649
(716) 985-6638
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
28815
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3317357
NCPDP
NY
Enumeration date
10/25/2006
Last updated
07/13/2022
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