Organization
SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK, INC.
Active
Parent organization
SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK,INC.
Other names
UNIVERSAL PRIMARY CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK,INC.
Authorized official
GAIL S MAYEAUX (CEO)
(716) 701-6831
Entity
Organization
Contact information
Practice address
445 BROAD ST, SALAMANCA, NY 14779-1424
(716) 375-7500
(716) 806-1287
Mailing address
135 N UNION ST # 716, OLEAN, NY 14760-2736
(716) 375-7500
(716) 806-1287
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
0401201R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02587231
—
NY
Enumeration date
12/06/2016
Last updated
02/09/2017
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