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NPI Code Detail

MEDICARE: COMMUNITY MEMORIAL HOSPITAL, INC

MEDICARE: COMMUNITY MEMORIAL HOSPITAL, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility2625000NNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184626897
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MEMORIAL HOSPITAL, INC
Provider Business Mailing Address
First Line : 150 BROAD ST
Second Line :
City : HAMILTON
State : NY
Zip : 13346-9575
Country : US
Telephone Number : 315-824-6082
Fax Number : 315-824-3182
Provider Business Practice Location Address
First Line : 150 BROAD ST
Second Line :
City : HAMILTON
State : NY
Zip : 13346-9575
Country : US
Telephone Number : 315-824-6082
Fax Number : 315-824-3182
Authorized Official
Title or Position : CEO
Name : SEAN FADALE
Credential :
Telephone Number : 315-824-6082
Provider Enumeration Date : 08/12/2005
Last Update Date : 08/02/2012

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Directions to “COMMUNITY MEMORIAL HOSPITAL, INC ” Practice Location

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