Provider Demographics
NPI:1104916022
Name:SCHOELLKOPF HEALTH CENTER
Entity type:Organization
Organization Name:SCHOELLKOPF HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT ACCOUNTS REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEXINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-278-4583
Mailing Address - Street 1:621 TENTH STREET
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14302-0708
Mailing Address - Country:US
Mailing Address - Phone:716-278-4583
Mailing Address - Fax:716-278-4876
Practice Address - Street 1:621 TENTH STREET
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14302-0708
Practice Address - Country:US
Practice Address - Phone:716-278-4583
Practice Address - Fax:716-278-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3102307N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356381Medicaid
NY00011258801OtherUNIVERA PROVIDER NO.
NYA5OtherIHA PROVIDER NO.
NYH6OtherIHA SA PROVIDER NO.
NY00000121OtherBC/BS PROVIDER NO.
NY=========OtherCOMM.INS.PROVIDER NO.
NY00356381Medicaid