=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700204641
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALBANY MEDICAL CENTER HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2014
-----------------------------------------------------
Last Update Date | 11/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1365 WASHINGTON AVE
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12206-1098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-489-4704
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 43 NEW SCOTLAND AVE MAIL CODE 114
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12208-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-262-3501
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE VP, CHIEF FINANCIAL OFFIC
-----------------------------------------------------
Name | MRS. FRANCES SPREER-ALBER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 518-262-8795
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------