Provider Demographics
NPI: | 1962747683 |
---|---|
Name: | SARATOGA HOSPITAL |
Entity type: | Organization |
Organization Name: | SARATOGA HOSPITAL |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GARY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FOSTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 518-583-8421 |
Mailing Address - Street 1: | PO BOX 3450 |
Mailing Address - Street 2: | |
Mailing Address - City: | SARATOGA SPRINGS |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 12866-8009 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 518-580-2020 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 119 LAWRENCE ST |
Practice Address - Street 2: | |
Practice Address - City: | SARATOGA SPRINGS |
Practice Address - State: | NY |
Practice Address - Zip Code: | 12866-1346 |
Practice Address - Country: | US |
Practice Address - Phone: | 518-584-7361 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | SARATOGA HOSPITAL |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2012-12-06 |
Last Update Date: | 2013-03-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 330222 | Other | MEDICARE PART A |