Healthcare Provider Details

I. General information

NPI: 1184706020
Provider Name (Legal Business Name): LEWIS COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7785 N STATE ST
LOWVILLE NY
13367-1229
US

IV. Provider business mailing address

7785 N STATE ST
LOWVILLE NY
13367-1229
US

V. Phone/Fax

Practice location:
  • Phone: 315-376-5200
  • Fax: 315-376-9317
Mailing address:
  • Phone: 315-376-5200
  • Fax: 315-376-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELE PRINCE
Title or Position: INTERIM CEO
Credential:
Phone: 315-376-5203