Provider Demographics
NPI:1790043172
Name:FEEDMORE WESTERN NEW YORK, INC.
Entity Type:Organization
Organization Name:FEEDMORE WESTERN NEW YORK, INC.
Other - Org Name:MEALS ON WHEELS FOR WESTERN NEW YORK, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-822-2002
Mailing Address - Street 1:100 JAMES E CASEY DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14206-2368
Mailing Address - Country:US
Mailing Address - Phone:716-822-2002
Mailing Address - Fax:716-822-0932
Practice Address - Street 1:100 JAMES E CASEY DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-2368
Practice Address - Country:US
Practice Address - Phone:716-822-2002
Practice Address - Fax:716-822-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03103362Medicaid