Provider Demographics
NPI:1407969397
Name:GLENS FALLS HOSPITAL
Entity Type:Organization
Organization Name:GLENS FALLS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:AMADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-926-5113
Mailing Address - Street 1:100 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-1000
Mailing Address - Fax:518-926-1919
Practice Address - Street 1:100 PARK ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4413
Practice Address - Country:US
Practice Address - Phone:518-926-1000
Practice Address - Fax:518-926-1919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLENS FALLS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-16
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
33S191Medicare Oscar/Certification