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General NPI Number Information
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NPI Number | 1154217776
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Entity Type | Organization
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Legal Business Name | COLUMBIA MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 283 MOUNTAIN VIEW RD
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City | COPAKE
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State | NY
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Zip | 12516-1201
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Country | US
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Telephone | 518-329-3902
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Fax |
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Provider Business Mailing Address
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Address Line | 71 PROSPECT AVE
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City | HUDSON
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State | NY
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Zip | 12534-2927
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRYAN T MAHONEY
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Credential |
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Telephone | 518-828-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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