Organization · Type 2 NPI

Jericho Road Ministries, Inc.

Federally Qualified Health Center (FQHC) · Buffalo, NY

NPI number 1619307022 Active

Practice location

21 Doat Street
Buffalo, NY 14211-1612

Call (716) 892-2775 Map

Fax (716) 597-0554

Other practice locations

1609 Genesee St, Buffalo, NY 14211-1616 · (716) 892-2775
19 Doat St, Buffalo, NY 14211-1612 · (716) 892-2775

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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NPI record

NPI: 1619307022
Entity type: Organization (Type 2)
Issued: Nov 21, 2013
Last updated: Sep 9, 2021
Status: Active
Subpart: Yes of Jericho Road Ministries Inc.

Other names

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Jericho Road Community Health Center · doing business as
Jericho Road Community Health Center · doing business as

Authorized official

Jackie Endress
Credentialing Specialist
(716) 348-3000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619307022

Jericho Road Ministries, Inc.'s National Provider Identifier is 1619307022, issued on Nov 21, 2013. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Buffalo, NY. The record was last updated on Sep 9, 2021.