Healthcare Provider Details

I. General information

NPI: 1487923637
Provider Name (Legal Business Name): ELIZABETHTOWN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 02/17/2024
Certification Date: 02/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PARK ST
ELIZABETHTOWN NY
12932
US

IV. Provider business mailing address

75 PARK ST
ELIZABETHTOWN NY
12932
US

V. Phone/Fax

Practice location:
  • Phone: 518-873-3130
  • Fax: 518-873-2315
Mailing address:
  • Phone: 518-873-6377
  • Fax: 518-873-3097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number30212
License Number StateNY

VIII. Authorized Official

Name: JULIE TROMBLEE
Title or Position: ASSISTANT DIRECTOR OF NURSING
Credential:
Phone: 518-873-3013