Provider Demographics
NPI:1437280955
Name:ORLEANS COMMUNITY HEALTH
Entity Type:Organization
Organization Name:ORLEANS COMMUNITY HEALTH
Other - Org Name:MEDINA MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SHURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-798-8101
Mailing Address - Street 1:200 OHIO STREET
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103
Mailing Address - Country:US
Mailing Address - Phone:585-798-2000
Mailing Address - Fax:585-798-8107
Practice Address - Street 1:11020 WEST CENTER STREET EXT.
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103
Practice Address - Country:US
Practice Address - Phone:585-798-2000
Practice Address - Fax:585-798-8107
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORLEANS COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-08
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3622000H261QE0700X
261QE0700X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3622700COtherLICENSE