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General NPI Number Information
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NPI Number | 1992707608
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 150 BROAD ST
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City | HAMILTON
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State | NY
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Zip | 13346-9575
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Country | US
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Telephone | 315-824-6082
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Fax | 315-824-3182
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Provider Business Mailing Address
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Address Line | 150 BROAD ST
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City | HAMILTON
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State | NY
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Zip | 13346-9575
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Country | US
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Telephone | 315-824-6082
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Fax | 315-824-3182
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Authorized Official
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Title or Position | CEO AND PRESIDENT
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Name | JEFFERY COAKLEY
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Credential |
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Telephone | 315-806-0909
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2625000H
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 2625700C
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License Number State | NY
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