Provider Demographics
NPI:1104583293
Name:ST. MARY'S HEALTHCARE
Entity type:Organization
Organization Name:ST. MARY'S HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL PERSON
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-770-7518
Mailing Address - Street 1:427 GUY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1064
Mailing Address - Country:US
Mailing Address - Phone:518-841-7401
Mailing Address - Fax:
Practice Address - Street 1:2370 ROUTE 67
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:151-830-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. MARY'S HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital