Provider Demographics
NPI:1003929050
Name:FIRST COMMUNITY CARE OF BASSETT, LLC
Entity Type:Organization
Organization Name:FIRST COMMUNITY CARE OF BASSETT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-568-2236
Mailing Address - Street 1:60 NORTHPOINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1883
Mailing Address - Country:US
Mailing Address - Phone:716-568-2236
Mailing Address - Fax:716-568-2243
Practice Address - Street 1:12 COMMONS DR
Practice Address - Street 2:SUITE 18
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-9516
Practice Address - Country:US
Practice Address - Phone:607-547-2173
Practice Address - Fax:607-547-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NY023319332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01913822Medicaid
NY01913822Medicaid