| Lewis County General Hospital | |
|
Copenhagen Health Center 9732 State Route 12 Copenhagen NY 13626-1362 | |
| (315) 688-2305 | |
| Not Available |
| Full Name | Lewis County General Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | Copenhagen Health Center, Copenhagen, New York |
| Authorized Official Name and Position | Michele Ann Prince (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 3153765246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis County General Hospital Lewis County General Hospital 7785n State St Lowville NY 13367 Ph: (315) 376-5246 | Lewis County General Hospital Copenhagen Health Center 9732 State Route 12 Copenhagen NY 13626-1362 Ph: (315) 688-2305 |
| NPI Number | 1235749979 |
|---|---|
| Provider Enumeration Date | 08/07/2020 |
| Last Update Date | 08/07/2020 |
| Medicare PECOS PAC ID | 2668463779 |
|---|---|
| Medicare Enrollment ID | O20201026000942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235749979 | NPI | - | NPPES |
| 03304574 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Roger B Shambo, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9732 State Route 12, Copenhagen, NY 13626 Phone: 315-688-2305 Fax: 315-688-2139 |