Provider Demographics
NPI:1558787762
Name:SCHOFIELD RESIDENCE INC.
Entity Type:Organization
Organization Name:SCHOFIELD RESIDENCE INC.
Other - Org Name:SCHOFIELD NHTD PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERLACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-874-1566
Mailing Address - Street 1:3333 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1013
Mailing Address - Country:US
Mailing Address - Phone:716-874-1566
Mailing Address - Fax:716-874-6942
Practice Address - Street 1:2757 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1609
Practice Address - Country:US
Practice Address - Phone:716-874-2600
Practice Address - Fax:716-873-2265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHOFIELD RESIDENCE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-12
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health