JERICHO ROAD MINISTRIES INC. NPI 1952893091

NPI Information

NPI: 1952893091
Provider Name: JERICHO ROAD MINISTRIES, INC.

Doing Business As: JERICHO ROAD COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 33D2192904

Address:
1021 BROADWAY ST
BUFFALO, NY
ZIP 14212
Phone: (716) 529-3020
Get Directions

JERICHO ROAD MINISTRIES, INC. is a federally qualified health center (fqhc) clinic center in Buffalo, NY. JERICHO ROAD MINISTRIES, INC. NPI is 1952893091. The provider is registered as an organization entity type.
The provider Is Doing Business As Jericho Road Community Health Center.

The provider's business location address is:

1021 BROADWAY ST
BUFFALO, NY
ZIP 14212-460
Phone: (716) 529-3020
Fax: (716) 529-3040

The provider's authorized official is Jackie Endress .
The authorized official title is Credentialing Specialist and has the following contact phone number (716) 348-3000.

The CLIA number assigned to this NPI record is 33D2192904 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/5/2018 and was last updated on 8/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	1401237R	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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