Organization
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHELLE LEBEAU (PRESIDENT/COO)
(518) 562-7055
Entity
Organization
Contact information
Practice address
75 BEEKMAN ST, PLATTSBURGH, NY 12901-1438
(518) 561-2000
(518) 561-0881
Mailing address
PO BOX 2868, PLATTSBURGH, NY 12901-0259
(518) 561-2000
(518) 561-0881
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0901001N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000400019000
BLUE SHIELD
NY
01
—
000919
UHC
NY
05
—
00319604
—
NY
01
—
10013988
CDPHP
NY
01
—
13551
GHI-FHP
NY
01
—
330250
EXCELLUS
NY
01
—
60054
AETNA
NY
01
—
61101
GHI-NYC
NY
01
—
90031
MVP
NY
Enumeration date
12/13/2006
Last updated
02/21/2024
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