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Organization

CLAXTON-HEPBURN MEDICAL CENTER

Active
Parent organization
CLAXTON HEPBURN MEDICAL CENTER
Other names
Dr. Ravinder Agarwal Renal Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
CLAXTON HEPBURN MEDICAL CENTER
Authorized official
CARRIE BOVA (REVENUE CYCLE DIRECTOR)
(315) 713-5354
Entity
Organization

Contact information

Practice address
214 KING ST, OGDENSBURG, NY 13669-1142
(315) 393-8880
(315) 393-7250
Mailing address
214 KING ST, OGDENSBURG, NY 13669-1142
(315) 394-9718
(315) 393-7250

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
4401000H
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00354072
NY
05
02966989
NY
Enumeration date
12/13/2006
Last updated
08/25/2021
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