1700204641 NPI number — ALBANY MEDICAL CENTER HOSPITAL

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 1700204641 NPI number — ALBANY MEDICAL CENTER HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBANY MEDICAL CENTER HOSPITAL
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:
AMCH COMMUNITY ENDOCRINOLOGY LABORATORY
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:
1700204641
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43 NEW SCOTLAND AVE
Provider Second Line Business Mailing Address:
MAIL CODE 114
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12208-3412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-262-3501
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1365 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12206-1098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-489-4704
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SPREER-ALBER
Authorized Official First Name:
FRANCES
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VP, CHIEF FINANCIAL OFFIC
Authorized Official Telephone Number:
518-262-8795

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 03000364 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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