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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