Organization
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Active
Other names
Lakeside Women's Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID W. FISHER (CEO)
(585) 637-3905
Entity
Organization
Contact information
Practice address
156 WEST AVE, SUITE 104, BROCKPORT, NY 14420-1229
(585) 637-6040
Mailing address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM1000X
Migrant Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355308
—
NY
Enumeration date
08/24/2007
Last updated
03/14/2008
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