Organization
DERUYTER HEALTH CENTER
Active
Parent organization
FAMILY HEALTH NETWORK
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY HEALTH NETWORK
Authorized official
WALTER PRIEST (EXECUTIVE DIRECTOR)
(607) 753-3797
Entity
Organization
Contact information
Practice address
5729 STATE ROUTE 13, DERUYTER, NY 13052-0364
(315) 852-3318
(315) 852-9997
Mailing address
17 MAIN ST, SUITE 302, CORTLAND, NY 13045-6606
(607) 753-3797
(607) 753-6677
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331863
MEDICARE PTAN
NY
Enumeration date
08/04/2009
Last updated
08/04/2009
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