Provider Demographics
NPI:1487653853
Name:HERKIMER COUNTY
Entity Type:Organization
Organization Name:HERKIMER COUNTY
Other - Org Name:HERKIMER COUNTY PUBLIC HEALTH NURSING SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-867-1176
Mailing Address - Street 1:301 N WASHINGTON ST
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-1299
Mailing Address - Country:US
Mailing Address - Phone:315-867-1176
Mailing Address - Fax:315-867-1262
Practice Address - Street 1:301 N WASHINGTON ST
Practice Address - Street 2:SUITE 2300
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1299
Practice Address - Country:US
Practice Address - Phone:315-867-1176
Practice Address - Fax:315-867-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2124600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473712Medicaid
NY00473712Medicaid