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General NPI Number Information
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NPI Number | 1518768068
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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 | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 10 GRANDVIEW AVENUE
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City | CATSKILL
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State | NY
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Zip | 12414
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Country | US
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Telephone | 518-943-9100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2000
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City | HUDSON
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State | NY
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Zip | 12534-2000
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Country | US
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Telephone | 518-828-8051
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPECIALIST
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Name | MARY LOU STAIB
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Credential |
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Telephone | 518-697-3258
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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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