Organization Name: | COLUMBIA MEMORIAL HOSPITAL |
NPI Number: | 1073960225 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRYAN MAHONEY (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 283 Mountain View Rd Copake |
State: | NY US |
Postal Code: | 125161201 |
Phone Number: | 5183293902 |
Fax Number: | 5183293903 |
NPI Enumeration Date: | 05/18/2016 |
NPI Last Update Date: | 05/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | 1001000H |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |