Provider Demographics
NPI:1932460276
Name:DEMAY LIVING CENTER
Entity Type:Organization
Organization Name:DEMAY LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:315-332-2464
Mailing Address - Street 1:100 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1068
Mailing Address - Country:US
Mailing Address - Phone:315-332-2700
Mailing Address - Fax:315-332-2702
Practice Address - Street 1:100 SUNSET DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1068
Practice Address - Country:US
Practice Address - Phone:315-332-2700
Practice Address - Fax:315-332-2702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAYNE HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3820000N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355702Medicaid
NY33-5403Medicare PIN