# COLUMBIA MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medication Assisted Treatment Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851775894
- **Authorized official:** SHANNON ELLSWORTH (OPERATIONS MANAGER)
- **Authorized official phone:** (518) 828-8067

## Contact information

- **Practice address:** 71 PROSPECT AVE, SUITE 240, HUDSON, NY 12534-2907
- **Practice address phone:** (518) 828-7601
- **Mailing address:** PO BOX 2000, HUDSON, NY 12534-2000
- **Mailing address phone:** (518) 828-8051
- **Mailing address fax:** (518) 697-3117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 1001000H | NY | Yes |

## Other

- **Enumeration date:** 07/18/2015
- **Last updated:** 04/09/2019