Provider Demographics
NPI:1528152386
Name:COUNTY OF WARREN
Entity type:Organization
Organization Name:COUNTY OF WARREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGGART
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:518-761-6540
Mailing Address - Street 1:42 GURNEY LN
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-8250
Mailing Address - Country:US
Mailing Address - Phone:518-761-6548
Mailing Address - Fax:518-761-6590
Practice Address - Street 1:42 GURNEY LN
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-8250
Practice Address - Country:US
Practice Address - Phone:518-761-6548
Practice Address - Fax:518-761-6590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5601302N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473794Medicaid
NY00473794Medicaid
NY81077AMedicare PIN