Provider Demographics
NPI:1487923637
Name:ELIZABETHTOWN COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:ELIZABETHTOWN COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TROMBLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-873-3013
Mailing Address - Street 1:75 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12932
Mailing Address - Country:US
Mailing Address - Phone:518-873-6377
Mailing Address - Fax:518-873-3097
Practice Address - Street 1:75 PARK ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932
Practice Address - Country:US
Practice Address - Phone:518-873-3130
Practice Address - Fax:518-873-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30212341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00354274Medicaid
NY70037AMedicare PIN