Provider Demographics
NPI:1871359000
Name:ADIRONDACK MEDICAL CENTER
Entity type:Organization
Organization Name:ADIRONDACK MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADELE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKREIGN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-897-4725
Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983
Mailing Address - Country:US
Mailing Address - Phone:518-897-4725
Mailing Address - Fax:
Practice Address - Street 1:309 COUNTY ROUTE 47 STE 4
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5426
Practice Address - Country:US
Practice Address - Phone:518-891-1610
Practice Address - Fax:518-891-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty