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NPI Code Detail

MEDICARE: FORT HUDSON NURSING CENTER, INC.

MEDICARE: FORT HUDSON NURSING CENTER, 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
1261QA0600XAdult Day Care Clinic/Center5724302NNY

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 : 1477639680
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORT HUDSON NURSING CENTER, INC.
Provider Business Mailing Address
First Line : 319 BROADWAY
Second Line :
City : FORT EDWARD
State : NY
Zip : 12828-1221
Country : US
Telephone Number : 518-747-2811
Fax Number : 518-747-2740
Provider Business Practice Location Address
First Line : 319 BROADWAY
Second Line :
City : FORT EDWARD
State : NY
Zip : 12828-1221
Country : US
Telephone Number : 518-747-2811
Fax Number : 518-747-2740
Authorized Official
Title or Position : ADMINISTRATOR/CEO
Name : MR. ANDREW A. CRUIKSHANK
Credential : RN, LNHA
Telephone Number : 518-747-2811
Provider Enumeration Date : 10/31/2006
Last Update Date : 08/22/2020

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