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Organization

COLUMBIA MEMORIAL HOSPITAL

Active
Other names
Medication Assisted Treatment Services
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON ELLSWORTH (OPERATIONS MANAGER)
(518) 828-8067
Entity
Organization

Contact information

Practice address
71 PROSPECT AVE, SUITE 240, HUDSON, NY 12534-2907
(518) 828-7601
Mailing address
PO BOX 2000, HUDSON, NY 12534-2000
(518) 828-8051
(518) 697-3117

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
1001000H
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03227290
NY
Enumeration date
07/18/2015
Last updated
04/09/2019
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