Provider Demographics
NPI:1346620408
Name:ALBANY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:ALBANY GENERAL HOSPITAL
Other - Org Name:SAMARITAN ENDOCRINOLOGY AGH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRIEBES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:541-812-4102
Mailing Address - Street 1:1086 7TH AVENUE SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANYR
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1954
Mailing Address - Country:US
Mailing Address - Phone:541-768-7900
Mailing Address - Fax:
Practice Address - Street 1:1086 7TH AVENUE SW
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBANYR
Practice Address - State:OR
Practice Address - Zip Code:97321-1954
Practice Address - Country:US
Practice Address - Phone:541-768-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14-1459207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty