| Rome Memorial Hospital, Inc | |
| 
					5 Masonic Ave Camden NY 13316-1234  | |
| (315) 245-3192 | |
| (315) 245-3195 | 
| Full Name | Rome Memorial Hospital, Inc | 
|---|---|
| Speciality | Clinic/center - Primary Care | 
| Location | 5 Masonic Ave, Camden, New York | 
| Authorized Official Name and Position | Ann Marie Czyz (PRESIDENT/CEO) | 
| Authorized Official Contact | 3153371200 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Rome Memorial Hospital, Inc 245 Avery Ln Rome NY 13441-4237 Ph: (315) 337-1200  | Rome Memorial Hospital, Inc 5 Masonic Ave Camden NY 13316-1234 Ph: (315) 245-3192  | 
| NPI Number | 1891113965 | 
|---|---|
| Provider Enumeration Date | 04/04/2014 | 
| Last Update Date | 07/10/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1891113965 | NPI | - | NPPES | 
| 04235030 | Medicaid | NY | |
| 03001434 | Medicaid | NY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (New York) | Primary |