Provider Demographics
NPI:1609873520
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:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:MARK
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 ST
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:585-798-8444
Practice Address - Street 1:200 OHIO ST
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:585-798-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3622700C282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3622700COtherLICENSE
NY333526Medicare Oscar/Certification
NY331319Medicare Oscar/Certification
NY33R319Medicare Oscar/Certification
NY1821376484Medicare Oscar/Certification
NY3622700CMedicaid
NY335313Medicare Oscar/Certification
NY337222Medicare Oscar/Certification
NY33Z319Medicare Oscar/Certification