Provider Demographics
NPI:1174419196
Name:MARY IMOGENE BASSETT HOSPITAL
Entity type:Organization
Organization Name:MARY IMOGENE BASSETT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VIELKIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-823-5281
Mailing Address - Street 1:1 FOXCARE DR STE 215
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2154
Mailing Address - Country:US
Mailing Address - Phone:607-431-5959
Mailing Address - Fax:
Practice Address - Street 1:1 FOXCARE DR STE 215
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2154
Practice Address - Country:US
Practice Address - Phone:607-431-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARY IMOGENE BASSETT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy