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BETHANY VILLAGE PRIMARY CARE NETWORK, INC.

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Company Details

Name: BETHANY VILLAGE PRIMARY CARE NETWORK, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 03 Oct 2016 (9 years ago)
Entity Number: 5017451
ZIP code: 14845
County: Chemung
Place of Formation: New York
Address: 3005 WATKINS ROAD, HORSEHEADS, NY, United States, 14845

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 3005 WATKINS ROAD, HORSEHEADS, NY, United States, 14845

National Provider Identifier

NPI Number:
1811434103

Authorized Person:

Name:
MR. MICHAEL KISER
Role:
CHIEF FINANCIAL OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
261QU0200X - Urgent Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6073786668

Filings

Filing Number Date Filed Type Effective Date
161003000073 2016-10-03 CERTIFICATE OF INCORPORATION 2016-10-03

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State