1851601108 NPI number — ADIRONDACK MEDICAL CENTER

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 1851601108 NPI number — ADIRONDACK MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADIRONDACK MEDICAL CENTER
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:
1851601108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
285 COUNTY ROUTE 47
Provider Second Line Business Mailing Address:
WOUND & HYPERBARIC TREATMENT CENTER
Provider Business Mailing Address City Name:
SARANAC LAKE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12983-5403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-897-2479
Provider Business Mailing Address Fax Number:
518-897-2530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
285 COUNTY ROUTE 47
Provider Second Line Business Practice Location Address:
WOUND & HYPERBARIC TREATMENT CENTER
Provider Business Practice Location Address City Name:
SARANAC LAKE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12983-5403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-897-2479
Provider Business Practice Location Address Fax Number:
518-897-2530
Provider Enumeration Date:
10/20/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRUCE
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MEDICAL BILLING COORDINATOR
Authorized Official Telephone Number:
518-897-2479

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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