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General NPI Number Information
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NPI Number | 1891785184
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Entity Type | Organization
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Legal Business Name | ELIZABETHTOWN COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 02/17/2024
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Provider Practice Location Address
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Address Line | 75 PARK ST
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City | ELIZABETHTOWN
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State | NY
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Zip | 12932-2300
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Country | US
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Telephone | 518-873-6377
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Fax | 518-873-2315
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Provider Business Mailing Address
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Address Line | 75 PARK ST PO BOX 277
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City | ELIZABETHTOWN
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State | NY
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Zip | 12932-0277
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Country | US
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Telephone | 518-873-6377
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Fax | 518-873-2315
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Authorized Official
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Title or Position | CEO
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Name | MR. RODNEY BOULA
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Credential |
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Telephone | 518-873-6377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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