Healthcare Provider Details

I. General information

NPI: 1417299546
Provider Name (Legal Business Name): FREDERICK FERRIS THOMPSON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 PARRISH ST
CANANDAIGUA NY
14424-1731
US

IV. Provider business mailing address

350 PARRISH ST
CANANDAIGUA NY
14424-1731
US

V. Phone/Fax

Practice location:
  • Phone: 585-396-6000
  • Fax:
Mailing address:
  • Phone: 585-396-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL STAPLETON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 585-396-6000