Organization
ALICE HYDE MEDICAL CENTER
Active
Other names
Alice Hyde Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA M MACDONALD (CONTROLLER)
(518) 481-2212
Entity
Organization
Contact information
Practice address
133 PARK ST, MALONE, NY 12953-1243
(518) 481-2212
Mailing address
133 PARK ST, MALONE, NY 12953-1220
(518) 481-2212
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
1624000H
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354114
—
NY
Enumeration date
12/20/2006
Last updated
05/15/2012
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