Organization
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Active
Parent organization
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Other names
Oak Orchard Health - Lyndonville
Organization subpart
Yes
Provider details
NPI number
Legal business name
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Authorized official
MS. MARY ANN PETTIBON (CEO)
(585) 637-3905
Entity
Organization
Contact information
Practice address
77 S MAIN ST, LYNDONVILLE, NY 14098-9771
(585) 765-2060
(585) 765-2067
Mailing address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1000X
Migrant Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355308
—
NY
Enumeration date
09/08/2009
Last updated
07/09/2021
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