| Organization Name: | GUTHRIE AHC |
| NPI Number: | 1093920811 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY DRAPER (ACTING UBO MANAGER) |
| Mailing Address: | 10205 N Riva Ridge Loop Suite P10506 Fort Drum |
| State: | NY US |
| Postal Code: | 136025457 |
| Phone Number: | 3157722778 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 03/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Military/U.S. Coast Guard Outpatient |
| Taxonomy Definition: | The Defense Health Program or U.S. Coast Guard funded |