Organization
HERITAGE VILLAGE REHAB AND SKILLED NURSING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BOSWELL (VICE PRESIDENT OF FINANCE)
(716) 338-9766
Entity
Organization
Contact information
Practice address
4600 ROUTE 60, GERRY, NY 14740-9562
(716) 985-4649
(716) 985-6638
Mailing address
4600 ROUTE 60, GERRY, NY 14740-9562
(716) 985-4649
(716) 985-6638
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
28815
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3317357
NCPDP
NY
Enumeration date
10/25/2006
Last updated
07/13/2022
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