Provider Demographics
NPI:1720622012
Name:ERIE COUNTY CARE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:ERIE COUNTY CARE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:MCGRATH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, CGMA
Authorized Official - Phone:814-528-0815
Mailing Address - Street 1:1601 SASSAFRAS ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1858
Mailing Address - Country:US
Mailing Address - Phone:814-528-0600
Mailing Address - Fax:814-528-0703
Practice Address - Street 1:1601 SASSAFRAS ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1858
Practice Address - Country:US
Practice Address - Phone:814-528-0600
Practice Address - Fax:814-528-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017542210012Medicaid