Provider Demographics
NPI:1366923534
Name:AUBURN COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:AUBURN COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-253-1760
Mailing Address - Street 1:17 LANSING STREET
Mailing Address - Street 2:PHARMACY
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1983
Mailing Address - Country:US
Mailing Address - Phone:315-255-7307
Mailing Address - Fax:315-255-7020
Practice Address - Street 1:17 LANSING STREET
Practice Address - Street 2:PHARMACY
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1983
Practice Address - Country:US
Practice Address - Phone:315-255-7307
Practice Address - Fax:315-255-7020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUBURN COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-27
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0007683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00347553Medicaid