Healthcare Provider Details

I. General information

NPI: 1346620408
Provider Name (Legal Business Name): ALBANY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 7TH AVE SW STE 200
ALBANY OR
97321-1997
US

IV. Provider business mailing address

PO BOX 1189
CORVALLIS OR
97339-1189
US

V. Phone/Fax

Practice location:
  • Phone: 541-768-7900
  • Fax:
Mailing address:
  • Phone: 541-768-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number14-1459
License Number StateOR

VIII. Authorized Official

Name: DANIEL KETERI
Title or Position: CEO-SAGH
Credential:
Phone: 541-812-4102