Organization
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
Active
Other names
CVPH Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
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
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0901001H
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000400019000
BLUE SHIELD NENY
NY
05
—
00318814
—
NY
01
—
00919
EMPIRE
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
03/09/2007
Last updated
10/10/2024
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