Healthcare Provider Details

I. General information

NPI: 1255639043
Provider Name (Legal Business Name): OSWEGO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W 6TH ST
OSWEGO NY
13126-2507
US

IV. Provider business mailing address

110 W 6TH ST
OSWEGO NY
13126-2507
US

V. Phone/Fax

Practice location:
  • Phone: 315-349-5511
  • Fax: 315-349-5785
Mailing address:
  • Phone: 315-349-5511
  • Fax: 315-349-5785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number3702000H
License Number StateNY

VIII. Authorized Official

Name: ERIC T CAMPBELL
Title or Position: CFO
Credential:
Phone: 315-349-5531