Healthcare Provider Details

I. General information

NPI: 1962224162
Provider Name (Legal Business Name): ROME MEMORIAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N JAMES ST
ROME NY
13440-2844
US

IV. Provider business mailing address

PO BOX 2000
EAST SYRACUSE NY
13057
US

V. Phone/Fax

Practice location:
  • Phone: 315-338-7000
  • Fax:
Mailing address:
  • Phone: 315-362-5129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: NATHAN SMITH
Title or Position: AVP FINANCE
Credential:
Phone: 315-338-7597