Organization
SOUTHERN TIER HOME MEDICAL SUPPLIES, INC.
Active
Organization
SOUTHERN TIER HOME MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY KAY NOLLER (CHIEF FINANCIAL OFFICER)
(585) 593-3050
Entity
Organization
Contact information
Practice address
67 N MAIN ST, WELLSVILLE, NY 14895-1249
(585) 593-3050
(585) 593-3051
Mailing address
67 N MAIN ST, WELLSVILLE, NY 14895-1249
(585) 593-3050
(585) 593-3051
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030021601
UNIVERA
NY
01
—
000551026001
BLUE CROSS OF WESTERN NY
NY
05
—
00888459
—
NY
Enumeration date
11/21/2006
Last updated
08/22/2020
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