Provider Demographics
NPI:1831283985
Name:COLUMBIA COUNTY DEPARTMENT OF HEALTH
Entity type:Organization
Organization Name:COLUMBIA COUNTY DEPARTMENT OF HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-828-4278
Mailing Address - Street 1:325 COLUMBIA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1902
Mailing Address - Country:US
Mailing Address - Phone:518-828-4278
Mailing Address - Fax:518-671-6738
Practice Address - Street 1:325 COLUMBIA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1902
Practice Address - Country:US
Practice Address - Phone:518-828-4278
Practice Address - Fax:518-671-6738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
2301493OtherAETNA US HEALTHCARE
10002521OtherCAPITAL DISTRICT PHP
000499404001OtherBLUE CROSS BLUE SHIELD
000499404001OtherBLUE SHIELD NENY
004569OtherEMPIRE BCBS
NY00473258Medicaid
113641OtherWELLCARE
13641OtherGHI HMO
NY03003752Medicaid
986047OtherMVP
0041968OtherGROUP HEALTH INC
040401000513OtherFIDELIS CARE OF NY
2301493OtherAETNA US HEALTHCARE
=========OtherUNITED HEALTHCARE
=========OtherCIGNA