Provider Demographics
NPI:1265658140
Name:WARREN COUNTY HEALTH SERVICES
Entity Type:Organization
Organization Name:WARREN COUNTY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:518-761-6415
Mailing Address - Street 1:1340 STATE ROUTE 9
Mailing Address - Street 2:MUNICIPAL CENTER
Mailing Address - City:LAKE GEORGE
Mailing Address - State:NY
Mailing Address - Zip Code:12845-3434
Mailing Address - Country:US
Mailing Address - Phone:518-761-6415
Mailing Address - Fax:518-761-6562
Practice Address - Street 1:1340 STATE ROUTE 9
Practice Address - Street 2:MUNICIPAL CENTER
Practice Address - City:LAKE GEORGE
Practice Address - State:NY
Practice Address - Zip Code:12845-3434
Practice Address - Country:US
Practice Address - Phone:518-761-6415
Practice Address - Fax:518-761-6562
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WARREN COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-18
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473698Medicaid