Healthcare Provider Details

I. General information

NPI: 1619138641
Provider Name (Legal Business Name): CARTHAGE AREA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 05/13/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22075 CONSTITUTION DRIVE
CARTHAGE NY
13619-1252
US

IV. Provider business mailing address

1001 WEST ST
CARTHAGE NY
13619-9703
US

V. Phone/Fax

Practice location:
  • Phone: 315-493-4187
  • Fax: 315-493-4188
Mailing address:
  • Phone: 315-519-5724
  • Fax: 315-493-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number2238001H
License Number StateNY

VIII. Authorized Official

Name: RICHARD DUVALL
Title or Position: CEO ADMINISTRATOR
Credential:
Phone: 315-519-5201