Provider Demographics
NPI:1659637817
Name:ALBANY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:ALBANY GENERAL HOSPITAL
Other - Org Name:SAMARITAN ALBANY PULMONOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIEBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-812-4102
Mailing Address - Street 1:400 HICKORY ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1700
Mailing Address - Country:US
Mailing Address - Phone:541-812-5877
Mailing Address - Fax:541-812-5032
Practice Address - Street 1:400 HICKORY ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1700
Practice Address - Country:US
Practice Address - Phone:541-812-5877
Practice Address - Fax:541-812-5032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty