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Organization

QC-MEDI NEW YORK, INC.

Active
Other names
CenterWell Home Health
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(607) 962-0102
Entity
Organization

Contact information

Practice address
11849 E CORNING RD, SUITE 108, CORNING, NY 14830-3695
(607) 962-0102
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00011327202
G2
01
000161506
G2
01
000400510005
1B
01
013100P
G2
05
01447763
NY
01
098251
G2
01
112256479
G2
01
11225647902
G2
01
112645333
G2
01
112802024
G2
01
116529
G2
01
120243
G2
01
202035301
G2
01
335394
G2
01
337224
G2
01
337292
G2
01
520115
G2
01
7215344
G2
Enumeration date
07/06/2006
Last updated
09/02/2022
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