Basic Information
| Provider Information | |||||||||
| NPI: | 1689741985 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BASSETT HOSPITAL OF SCHOHARIE COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 178 GRANDVIEW DR | ||||||||
| Address2: | |||||||||
| City: | COBLESKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120435144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182543270 | ||||||||
| FaxNumber: | 5182344839 | ||||||||
| Practice Location | |||||||||
| Address1: | 178 GRANDVIEW DR | ||||||||
| Address2: | |||||||||
| City: | COBLESKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120435144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182543270 | ||||||||
| FaxNumber: | 5182344839 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2006 | ||||||||
| LastUpdateDate: | 01/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | MARRYOTT | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
| AuthorizedOfficialMiddleName: | MARK | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT - REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 6075476947 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | 4720001H | NY | N | Hospital Units | Medicare Defined Swing Bed Unit | 282NC0060X | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | 00302429 | 05 | NY | MEDICAID |