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General NPI Number Information
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NPI Number | 1306930318
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Entity Type | Organization
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Legal Business Name | IRA DAVENPORT MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 7571 STATE ROUTE 54
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City | BATH
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State | NY
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Zip | 14810-9504
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Country | US
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Telephone | 607-776-8500
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Fax | 607-776-8800
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Provider Business Mailing Address
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Address Line | 7571 STATE ROUTE 54
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City | BATH
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State | NY
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Zip | 14810
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Country | US
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Telephone | 607-776-8500
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Fax | 607-776-8800
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Authorized Official
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Title or Position | PRESIDENT & CHIEF EXECUTIVE OFFICER
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Name | MR. JONATHAN I. LAWRENCE
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Credential |
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Telephone | 607-776-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number |
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License Number State |
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