Provider Demographics
NPI:1487931093
Name:PALLIATIVE HOME CARE OF NIAGARA, INC.
Entity type:Organization
Organization Name:PALLIATIVE HOME CARE OF NIAGARA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:LOMEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-439-4417
Mailing Address - Street 1:2424 NIAGARA FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-4562
Mailing Address - Country:US
Mailing Address - Phone:716-274-5000
Mailing Address - Fax:716-731-1725
Practice Address - Street 1:2424 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-4562
Practice Address - Country:US
Practice Address - Phone:716-274-5000
Practice Address - Fax:716-731-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11152001OtherNY STATE LICENSE
NY03498919Medicaid