Provider Demographics
NPI:1477620797
Name:UR MEDICINE HOME CARE, LICENSED SERVICES, INC.
Entity Type:Organization
Organization Name:UR MEDICINE HOME CARE, LICENSED SERVICES, INC.
Other - Org Name:VISITING NURSE SIGNATURE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-274-4225
Mailing Address - Street 1:2180 EMPIRE BLVD.
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2029
Mailing Address - Country:US
Mailing Address - Phone:585-787-2233
Mailing Address - Fax:585-787-8740
Practice Address - Street 1:2180 EMPIRE BLVD.
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2029
Practice Address - Country:US
Practice Address - Phone:585-787-2233
Practice Address - Fax:585-787-8740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0761L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01045303Medicaid
NYCC160146OtherBLUE CROSS BLUE SHIELD
NY103366OtherPREFERRED CARE