Provider Demographics
NPI:1649202763
Name:INDEPENDENT NURSING CARE L.L.C
Entity Type:Organization
Organization Name:INDEPENDENT NURSING CARE L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEMEREK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:716-655-8776
Mailing Address - Street 1:1038 DAVID ROAD
Mailing Address - Street 2:PO BOX 489
Mailing Address - City:WEST FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14170-0489
Mailing Address - Country:US
Mailing Address - Phone:716-655-8776
Mailing Address - Fax:716-655-7877
Practice Address - Street 1:1038 DAVIS ROAD
Practice Address - Street 2:1038 DAVIS ROAD
Practice Address - City:WEST FALLS
Practice Address - State:NY
Practice Address - Zip Code:14170-0489
Practice Address - Country:US
Practice Address - Phone:716-655-8776
Practice Address - Fax:716-655-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1202L001251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00202877OtherRAILROAD MEDICARE
NY0007352073OtherAETNA
NY103356CIOtherPREFERRED CARE
NY8390051OtherINDEPENDENT HEALTH
NY00030463102OtherUNIVERA
NY000512767002OtherBLUE CROSS BLUE SHIELD
NY0007352073OtherAETNA