Provider Demographics
NPI:1568730612
Name:CORTLAND COUNTY HEALTH DEPARTMENT LICENSED HOME CARE SERVICES AGENCY
Entity Type:Organization
Organization Name:CORTLAND COUNTY HEALTH DEPARTMENT LICENSED HOME CARE SERVICES AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:FEUERHERM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN
Authorized Official - Phone:607-756-3401
Mailing Address - Street 1:60 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2746
Mailing Address - Country:US
Mailing Address - Phone:607-756-3401
Mailing Address - Fax:607-756-3483
Practice Address - Street 1:60 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2746
Practice Address - Country:US
Practice Address - Phone:607-756-3401
Practice Address - Fax:607-756-3483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1963L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health