| Hudson Headwaters Health Network | |
|
27 Hyland Dr Lake Luzerne NY 12846-3923 | |
| (518) 824-2580 | |
| (518) 824-2579 |
| Full Name | Hudson Headwaters Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 27 Hyland Dr, Lake Luzerne, New York |
| Authorized Official Name and Position | Laura Pasco (EXECUTIVE VP, CFO) |
| Authorized Official Contact | 5187610300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hudson Headwaters Health Network 9 Carey Rd Queensbury NY 12804-7880 Ph: (518) 761-0300 | Hudson Headwaters Health Network 27 Hyland Dr Lake Luzerne NY 12846-3923 Ph: (518) 824-2580 |
| NPI Number | 1528611084 |
|---|---|
| Provider Enumeration Date | 07/23/2019 |
| Last Update Date | 02/23/2024 |
| Medicare PECOS PAC ID | 7416861208 |
|---|---|
| Medicare Enrollment ID | O20191015000798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528611084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |