Provider Demographics
NPI:1497314652
Name:CLIFTON SPRINGS SANITARIUM CO
Entity Type:Organization
Organization Name:CLIFTON SPRINGS SANITARIUM CO
Other - Org Name:CLIFTON SPRINGS HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER PROVIDER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:585-922-0527
Mailing Address - Street 1:2 COULTER RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432-1122
Mailing Address - Country:US
Mailing Address - Phone:315-462-1250
Mailing Address - Fax:
Practice Address - Street 1:2 COULTER RD
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-1122
Practice Address - Country:US
Practice Address - Phone:315-462-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLIFTON SPRINGS SANITARIUM CO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-11
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy