Healthcare Provider Details

I. General information

NPI: 1386868289
Provider Name (Legal Business Name): NICHOLAS H. NOYES MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CLARA BARTON ST
DANSVILLE NY
14437
US

IV. Provider business mailing address

111 CLARA BARTON ST
DANSVILLE NY
14437-9503
US

V. Phone/Fax

Practice location:
  • Phone: 585-335-6001
  • Fax: 585-335-4282
Mailing address:
  • Phone: 585-335-6001
  • Fax: 585-335-4282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number252700H
License Number StateNY

VIII. Authorized Official

Name: MARK PRUNOSKE
Title or Position: CFO
Credential:
Phone: 585-335-6001