Healthcare Provider Details

I. General information

NPI: 1720299654
Provider Name (Legal Business Name): CARTHAGE AREA HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32787 US ROUTE 11
PHILADELPHIA NY
13673
US

IV. Provider business mailing address

1001 WEST ST
CARTHAGE NY
13619-9703
US

V. Phone/Fax

Practice location:
  • Phone: 315-493-1000
  • Fax: 315-493-0105
Mailing address:
  • Phone: 315-493-1000
  • Fax: 315-493-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number2238001H
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2238001H
License Number StateNY

VIII. Authorized Official

Name: WALTER BECKER
Title or Position: CEO ADMINISTRATOR
Credential:
Phone: 315-493-1000