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General NPI Number Information
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NPI Number | 1316016447
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Entity Type | Organization
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Legal Business Name | MOSES-LUDINGTON HOSPITAL
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 1019 WICKER ST
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City | TICONDEROGA
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State | NY
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Zip | 12883
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Country | US
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Telephone | 518-585-3700
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Fax | 518-585-3899
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Provider Business Mailing Address
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Address Line | 1019 WICKER ST
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City | TICONDEROGA
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State | NY
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Zip | 12883-1039
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Country | US
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Telephone | 518-585-3700
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Fax | 518-585-3899
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM HOLMES
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Credential |
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Telephone | 518-585-3720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 1564701C
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License Number State | NY
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