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NPI Code Detail

MEDICARE: MIDDLETOWN COMMUNITY HEALTH CENTER INC

MEDICARE: MIDDLETOWN COMMUNITY HEALTH 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
1122300000XDentistNY

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 : 1609055409
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDDLETOWN COMMUNITY HEALTH CENTER INC
Provider Business Mailing Address
First Line : PO BOX 987
Second Line : 21 ORCHARD STREET
City : MIDDLETOWN
State : NY
Zip : 10940
Country : US
Telephone Number : 845-856-8450
Fax Number : 845-343-5390
Provider Business Practice Location Address
First Line : 140 HAMMOND STREET
Second Line :
City : PORT JERVIS
State : NY
Zip : 12771-2607
Country : US
Telephone Number : 845-856-8450
Fax Number : 845-343-5390
Authorized Official
Title or Position : CEO
Name : MRS. THERESA MALONEY
Credential :
Telephone Number : 845-343-7614
Provider Enumeration Date : 10/29/2007
Last Update Date : 04/01/2011

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Directions to “MIDDLETOWN COMMUNITY HEALTH CENTER INC ” Practice Location

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