Provider Demographics
NPI:1760480891
Name:CORTLAND COUNTY
Entity Type:Organization
Organization Name:CORTLAND COUNTY
Other - Org Name:CORTLAND COUNTY HEALTH DEPARTMENT CERTIFIED HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:FEUERHERM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, NP
Authorized Official - Phone:607-753-5036
Mailing Address - Street 1:60 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2795
Mailing Address - Country:US
Mailing Address - Phone:607-753-5139
Mailing Address - Fax:607-753-5209
Practice Address - Street 1:60 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2795
Practice Address - Country:US
Practice Address - Phone:607-753-5028
Practice Address - Fax:607-756-3483
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORTLAND COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-12
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1101600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00474240Medicaid
NY1873OtherPFI
NY00474240Medicaid