| Mosaic Health, Inc. | |
|
1519 Nye Rd Lyons NY 14489-9133 | |
| (315) 871-3178 | |
| (844) 683-9216 |
| Full Name | Mosaic Health, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1519 Nye Rd, Lyons, New York |
| Authorized Official Name and Position | Lisa Olscamp (CFO) |
| Authorized Official Contact | 5853252280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Health, Inc. 1519 Nye Rd Lyons NY 14489-9133 Ph: (315) 871-3178 | Mosaic Health, Inc. 1519 Nye Rd Lyons NY 14489-9133 Ph: (315) 871-3178 |
| NPI Number | 1780010975 |
|---|---|
| Provider Enumeration Date | 09/19/2013 |
| Last Update Date | 09/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780010975 | NPI | - | NPPES |
| 00618199 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New York) | Primary |
County Of Wayne Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1519 Nye Rd, Suite 200, Lyons, NY 14489 Phone: 315-946-5749 Fax: 315-946-5762 |