Provider Demographics
NPI:1750350799
Name:GARNET HEALTH MEDICAL CENTER CATSKILLS
Entity type:Organization
Organization Name:GARNET HEALTH MEDICAL CENTER CATSKILLS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUDGET, REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-333-7446
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:
Mailing Address - City:HARRIS
Mailing Address - State:NY
Mailing Address - Zip Code:12742-0900
Mailing Address - Country:US
Mailing Address - Phone:845-794-3300
Mailing Address - Fax:845-794-1052
Practice Address - Street 1:68 HARRIS BUSHVILLE RD
Practice Address - Street 2:
Practice Address - City:HARRIS
Practice Address - State:NY
Practice Address - Zip Code:12742
Practice Address - Country:US
Practice Address - Phone:845-794-3300
Practice Address - Fax:845-794-1052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARNET HEALTH MEDICAL CENTER CATSKILLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-14
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5263000H314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00476031Medicaid
NY335639Medicare ID - Type UnspecifiedPROVIDER NUMBER