| Organization Name: | ELIZABETHTOWN COMMUNITY HOSPITAL |
| NPI Number: | 1053656744 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RODNEY BOULA (CEO) |
| Mailing Address: | 75 Park Street Elizabethtown |
| State: | NY US |
| Postal Code: | 12932 |
| Phone Number: | 5188739000 |
| Fax Number: | 5188733097 |
| NPI Enumeration Date: | 12/06/2012 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1552701C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |