Organization
QC-MEDI NEW YORK, INC.
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(315) 461-0209
Entity
Organization
Contact information
Practice address
115 CONTINUUM DR STE 2E, LIVERPOOL, NY 13088-4387
(315) 461-0209
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011327202
G2
—
01
—
000161506
G2
—
01
—
0003302145
G2
—
01
—
000900434000
1B
—
05
—
01085501
—
NY
01
—
040401001283
G2
—
01
—
112256479
G2
—
01
—
112645333
G2
—
01
—
112802024
G2
—
01
—
116529
G2
—
01
—
120243
G2
—
01
—
317065
G2
—
01
—
335394
G2
—
01
—
337255
G2
—
01
—
4411
G2
—
01
—
520119
G2
—
01
—
565800
G2
—
01
—
7215344
G2
—
Enumeration date
07/07/2006
Last updated
09/02/2022
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