Healthcare Provider Details

I. General information

NPI: 1689741985
Provider Name (Legal Business Name): BASSETT HOSPITAL OF SCHOHARIE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 01/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 GRANDVIEW DR
COBLESKILL NY
12043-5144
US

IV. Provider business mailing address

178 GRANDVIEW DR
COBLESKILL NY
12043-5144
US

V. Phone/Fax

Practice location:
  • Phone: 518-254-3270
  • Fax: 518-234-4839
Mailing address:
  • Phone: 518-254-3270
  • Fax: 518-234-4839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number4720001H
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: EDWARD MARK MARRYOTT
Title or Position: VICE PRESIDENT - REVENUE CYCLE
Credential:
Phone: 607-547-6947