# ST LAWRENCE COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST LAWRENCE COUNTY
- **Other names:** St Lawrence County Public Health - Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861551822
- **Legal business name:** ST LAWRENCE COUNTY
- **Authorized official:** DEBRA BRIDGES MBA (FISCAL MANAGER)
- **Authorized official phone:** (315) 229-3405

## Contact information

- **Practice address:** 80 STATE HIGHWAY 310 STE 2, CANTON, NY 13617-1476
- **Practice address phone:** (315) 386-2325
- **Practice address fax:** (315) 386-2203
- **Mailing address:** 80 STATE HIGHWAY 310 STE 2, CANTON, NY 13617-1476
- **Mailing address phone:** (315) 386-2325
- **Mailing address fax:** (315) 386-2203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 4423200R | NY | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 12/01/2015