Organization
COMMUNITY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LIEBEL (VP FINANCE)
(315) 824-6550
Entity
Organization
Contact information
Practice address
117 W MAIN ST, WATERVILLE, NY 13480-1165
(315) 841-4184
Mailing address
150 BROAD ST, HAMILTON, NY 13346-9575
(315) 824-6081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2017
Last updated
11/02/2023
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