1740442870 NPI number — GARNET HEALTH MEDICAL CENTER CATSKILLS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740442870 NPI number — GARNET HEALTH MEDICAL CENTER CATSKILLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GARNET HEALTH MEDICAL CENTER CATSKILLS
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:
CATSKILL REGIONAL MEDICAL CENTER
Provider Other Organization Name Type Code:
4
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:
1740442870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 900
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRIS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-794-3300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8881 NYS ROUTE 97
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALLICOON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-887-5530
Provider Business Practice Location Address Fax Number:
845-887-5380
Provider Enumeration Date:
06/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DAVISON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BUDGET, REIMBURSEMENT
Authorized Official Telephone Number:
845-333-7446

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , 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: 00273978 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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