=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740401041
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORANGE COUNTY DEPT. OF HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 124 MAIN ST
-----------------------------------------------------
City | GOSHEN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10924-2124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-291-2332
-----------------------------------------------------
Fax | 845-291-2341
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 MAIN ST
-----------------------------------------------------
City | GOSHEN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10924-2124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-291-2332
-----------------------------------------------------
Fax | 845-291-2341
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COMMISSIONER OF HEALTH
-----------------------------------------------------
Name | JEAN M HUDSON
-----------------------------------------------------
Credential | M.D,
-----------------------------------------------------
Telephone | 845-291-2332
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 3523901L
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------