Basic Information
| Provider Information | |||||||||
| NPI: | 1972548568 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIGHLAND HOSPITAL OF ROCHESTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 SOUTH AVE | ||||||||
| Address2: | PT ACCTS DEPT - BOX 76 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146202733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857849383 | ||||||||
| FaxNumber: | 5857568547 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 SOUTH AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146202733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854732200 | ||||||||
| FaxNumber: | 5853418350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2006 | ||||||||
| LastUpdateDate: | 11/10/2016 | ||||||||
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| AuthorizedOfficialLastName: | ANOLIK | ||||||||
| AuthorizedOfficialFirstName: | ADAM | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5852753033 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2701001H | NY | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 02998245 | 05 | NY | MEDICAID | 012005902 | 01 | NY | ROCHESTER BL CHOICE IP | OTHER | 00354307 | 05 | NY | MEDICAID | 70006A | 01 | NY | MEDICARE PART B CARRIER | OTHER | 014005902 | 01 | NY | ROCHESTER BL CHOICE OP | OTHER | 02 | 01 | NY | ROCHESTER BLUE CROSS | OTHER | 100000CF | 01 | NY | PREFERRED CARE | OTHER |