Provider Demographics
NPI:1942538368
Name:SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK INC
Entity Type:Organization
Organization Name:SOUTHERN TIER COMMUNITY HEALTH CENTER NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-701-6831
Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:716-332-3525
Practice Address - Street 1:9864 LUCKEY DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:NY
Practice Address - Zip Code:14744-8706
Practice Address - Country:US
Practice Address - Phone:716-701-6831
Practice Address - Fax:716-701-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty