Healthcare Provider Details
I. General information
NPI: 1174009112
Provider Name (Legal Business Name): LITTLE FALLS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2018
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36 SLAWSON ST
DOLGEVILLE NY
13329-1238
US
IV. Provider business mailing address
140 BURWELL ST
LITTLE FALLS NY
13365-1794
US
V. Phone/Fax
- Phone: 315-429-1784
- Fax: 315-429-7293
- Phone: 315-823-5281
- Fax: 315-823-5383
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
VIELKIND
Title or Position: CFO
Credential:
Phone: 315-823-5281