Provider Demographics
NPI:1306024864
Name:COMPUTER SCIENCE CORPORATON
Entity Type:Organization
Organization Name:COMPUTER SCIENCE CORPORATON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:STACIEMAE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:315-286-8303
Mailing Address - Street 1:27530 LIMESTONE RD
Mailing Address - Street 2:
Mailing Address - City:REDWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:13679-4108
Mailing Address - Country:US
Mailing Address - Phone:315-286-8303
Mailing Address - Fax:
Practice Address - Street 1:27530 LIMESTONE RD
Practice Address - Street 2:
Practice Address - City:REDWOOD
Practice Address - State:NY
Practice Address - Zip Code:13679
Practice Address - Country:US
Practice Address - Phone:315-286-8303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2645841251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health