1972548568 NPI number — HIGHLAND HOSPITAL OF ROCHESTER

Table of content: (NPI 1972548568)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972548568 NPI number — HIGHLAND HOSPITAL OF ROCHESTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGHLAND HOSPITAL OF ROCHESTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972548568
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 SOUTH AVE
Provider Second Line Business Mailing Address:
PT ACCTS DEPT - BOX 76
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14620-2733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-784-9383
Provider Business Mailing Address Fax Number:
585-756-8547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 SOUTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14620-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-473-2200
Provider Business Practice Location Address Fax Number:
585-341-8350
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANOLIK
Authorized Official First Name:
ADAM
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
585-275-3033

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  2701001H , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02998245 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012005902 . This is a "ROCHESTER BL CHOICE IP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00354307 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 70006A . This is a "MEDICARE PART B CARRIER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 014005902 . This is a "ROCHESTER BL CHOICE OP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02 . This is a "ROCHESTER BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 100000CF . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 010212200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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