1003811449 NPI number — COUNTY OF ULSTER NY

Table of content: (NPI 1003811449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003811449 NPI number — COUNTY OF ULSTER NY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ULSTER NY
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:
ULSTER COUNTY HEALTH DEPARTMENT
Provider Other Organization Name Type Code:
5
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:
1003811449
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
239 GOLDEN HILL LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINGSTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12401-6441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-340-3070
Provider Business Mailing Address Fax Number:
845-340-3086

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
239 GOLDEN HILL LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12401-6441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-340-3070
Provider Business Practice Location Address Fax Number:
845-340-3086
Provider Enumeration Date:
06/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
COMMISSIONER OF HEALTH
Authorized Official Telephone Number:
845-340-3009

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1874L001 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP0905X , with the licence number: 5501201R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 02993451 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3329 . This is a "GHI HMO SELECT, INC." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6049 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8300934 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10034286 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 103329 . This is a "WELLCARE OF NEW YORK INC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: TRICARE . This is a "001" identifier . This identifiers is of the category "OTHER".
  • Identifier: A1876138 . This is a "OXFORD HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 004714 . This is a "BLUE CROSS - EMPIRE" identifier . This identifiers is of the category "OTHER".