Healthcare Provider Details

I. General information

NPI: 1619140670
Provider Name (Legal Business Name): GUTHRIE CORTLAND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 HOMER AVE
CORTLAND NY
13045-1206
US

IV. Provider business mailing address

PO BOX 2060
CORTLAND NY
13045-0946
US

V. Phone/Fax

Practice location:
  • Phone: 607-756-3554
  • Fax: 607-756-3545
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name: DENISE WRINN
Title or Position: VICE PRESIDENT OF FINANCE/CFO
Credential:
Phone: 607-756-3526