Provider Demographics
NPI:1952418352
Name:GENEVA GENERAL HOSPITAL INC.
Entity type:Organization
Organization Name:GENEVA GENERAL HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-787-4031
Mailing Address - Street 1:196 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1651
Mailing Address - Country:US
Mailing Address - Phone:315-787-4150
Mailing Address - Fax:315-787-4794
Practice Address - Street 1:196 NORTH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1651
Practice Address - Country:US
Practice Address - Phone:315-787-4150
Practice Address - Fax:315-787-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12SOtherBLUE CROSS LAB
NY00378712Medicaid
NY014003712OtherBLUE CHOICE OUTPATIENT
NY106126AMOtherPREFERRED CARE DETOX
NY12OtherBLUE CROSS ACUTE
NY010043749OtherBLUE CHOICE LAB
NY012003712OtherBLUE CHOICE INPATIENT
NY100017CFOtherPREFERRED CARE ACUTE
NY12OtherBLUE CROSS ACUTE