Provider Demographics
NPI:1194776351
Name:THE FREDERICK FERRIS THOMPSON HOSPITAL
Entity type:Organization
Organization Name:THE FREDERICK FERRIS THOMPSON HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STAPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-396-6490
Mailing Address - Street 1:350 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1731
Mailing Address - Country:US
Mailing Address - Phone:585-396-6000
Mailing Address - Fax:585-396-6455
Practice Address - Street 1:350 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1731
Practice Address - Country:US
Practice Address - Phone:585-396-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3429000H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014003710OtherBLCH OP
NY014302437OtherBLCH LABS
NY10SOtherBCR LAB
NY012003710OtherBLCH IP
NY10OtherBCR
NY107060AZOtherPREFERRED CARE OPTION
NY00362529Medicaid
NY100004CFOtherPREFERRED CARE
NYY0174520OtherCHAMPUS
NYY0174520OtherCHAMPUS
NY330074Medicare Oscar/Certification