Organization
EHS, INC.
Active
Other names
Evergreen Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ANNE STACK (AVP OF REVENUE CYCLE MGMT)
(716) 880-7399
Entity
Organization
Contact information
Practice address
206 S ELMWOOD AVE, BUFFALO, NY 14201-2398
(716) 847-0212
(716) 847-0418
Mailing address
206 S ELMWOOD AVE, BUFFALO, NY 14201-2398
(716) 847-0212
(716) 847-0418
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
01218524
NY
207RI0200X
Infectious Disease Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
01711366
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02995357
—
NY
05
—
0F332484
—
NY
Enumeration date
05/09/2006
Last updated
11/29/2022
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