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NPI Code Detail

MEDICARE: COLUMBIA MEMORIAL HOSPITAL

MEDICARE: COLUMBIA MEMORIAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center1001000HNY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1W79533OTHERNYMEDICARE GROUP

General Provider Information

NPI Number : 1164777819
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBIA MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : PO BOX 2000
Second Line :
City : HUDSON
State : NY
Zip : 12534-2000
Country : US
Telephone Number : 518-828-8363
Fax Number : 518-697-3388
Provider Business Practice Location Address
First Line : 813 WARREN ST
Second Line :
City : HUDSON
State : NY
Zip : 12534-3007
Country : US
Telephone Number : 518-828-4125
Fax Number : 518-697-5378
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. VINCENT J DINGMAN III
Credential :
Telephone Number : 518-828-8249
Provider Enumeration Date : 07/18/2012
Last Update Date : 07/18/2012

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Directions to “COLUMBIA MEMORIAL HOSPITAL ” Practice Location

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