Provider Demographics
NPI:1477152627
Name:MARY IMOGENE BASSETT HOSPITAL
Entity Type:Organization
Organization Name:MARY IMOGENE BASSETT HOSPITAL
Other - Org Name:O'CONNOR OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER NETWORK OP PHARMACY SERV
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAURISANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-547-6528
Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1394
Mailing Address - Country:US
Mailing Address - Phone:607-547-6528
Mailing Address - Fax:
Practice Address - Street 1:460 ANDES RD STE A
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-7407
Practice Address - Country:US
Practice Address - Phone:607-746-0365
Practice Address - Fax:607-746-0360
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARY IMOGENE BASSETT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-20
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy