1568854438 NPI number — GARNET HEALTH MEDICAL CENTER-CATSKILLS

Table of content: (NPI 1568854438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568854438 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:
Provider Other Organization Name Type Code:
6
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:
1568854438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 800
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:
12742-0800
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 STATE 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:
12723-5052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-794-3300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2015

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: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282NC0060X , with the licence number: 5263700C , 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)





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