Healthcare Provider Details

I. General information

NPI: 1013759166
Provider Name (Legal Business Name): CARTHAGE AREA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 FORD AVE
OGDENSBURG NY
13669-1109
US

IV. Provider business mailing address

1001 WEST ST
CARTHAGE NY
13619-9776
US

V. Phone/Fax

Practice location:
  • Phone: 315-394-9718
  • Fax:
Mailing address:
  • Phone: 315-519-5724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY ELIZABETH GAZDA
Title or Position: CFO
Credential:
Phone: 315-706-9762