Healthcare Provider Details

I. General information

NPI: 1174671044
Provider Name (Legal Business Name): ALBANY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 EVERGREEN PLACE SE
ALBANY OR
97322-6182
US

IV. Provider business mailing address

1046 6TH AVE SW
ALBANY OR
97321-1916
US

V. Phone/Fax

Practice location:
  • Phone: 541-812-4460
  • Fax: 541-812-4661
Mailing address:
  • Phone: 541-812-4660
  • Fax: 541-812-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL KETERI
Title or Position: CEO
Credential:
Phone: 541-812-4104