Provider Demographics
NPI:1700145786
Name:ALBANY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:ALBANY GENERAL HOSPITAL
Other - Org Name:SAMARITAN KIDNEY SPECIALISTS - ALBANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KETERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-812-4102
Mailing Address - Street 1:631 ELM ST SW STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1952
Mailing Address - Country:US
Mailing Address - Phone:541-768-6930
Mailing Address - Fax:
Practice Address - Street 1:631 ELM ST SW STE 200
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1952
Practice Address - Country:US
Practice Address - Phone:541-768-6930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty