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Carthage Area Hospital Inc

Organization Active NPI Rural Health Clinic/Center · Waddington, NY

NPI 1871365072 · NPPES record last updated Oct 28, 2023

Key facts

NPI
1871365072
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CARTHAGE AREA HOSPITAL INC
Practice address
4 Montgomery HTS
Waddington, NY 13694-7712
Phone
(315) 388-7872
Fax
(315) 713-6511
NPI assigned
Oct 23, 2023
Organization subpart
No

Authorized official

Name
Morgan L Pierce
Title
VP of Finance
Phone
(315) 519-5725

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Facilities connected through Provider of Services related, parent or unit certification numbers.

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners 119

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 119

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY

Rural health clinic certification: CCN 333406

Legal name
CARTHAGE AREA HOSPITAL INC
Certification status
Terminated Voluntary: merger or closure, Nov 20, 2023
Provider type (POS)
Rural health clinic
Participating since
Dec 17, 2020
Last certification
Nov 8, 2023
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Oct 25, 1967 in NY
Enrollment address
4 Montgomery HTS
Waddington, NY 13694-7712
Related CCNs
331318

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dale Klock
Individual 		Corporate Director
Vice President of Board		 Jan 1, 2023
Andrew R Manzer
Individual 		Corporate Officer
Interim Ceo		 Mar 2, 2026
W-2 Managing Employee
Ad;		 Mar 2, 2026
Arnold R Hager
Individual 		Corporate Officer
VP of Revenue Cycle		 Sep 1, 2025
Jerian O'Dell
Individual 		Corporate Officer
Coo		 Apr 2, 2023
Mirza M Ashraf
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Tim Sturick
Individual 		Corporate Director
Treasurer of Board		 Jan 1, 2023
Gary Rowe
Individual 		Corporate Director
President of Board		 Jan 1, 2023
Larry Hasseler
Individual 		Corporate Director
Secretary of Board		 Jan 1, 2023

Change-of-ownership history

DateEventCounterparty
Dec 19, 2023 Change of Ownership
This provider was the buyer		 Claxton-Hepburn Medical Center
CCN 333406 · NY · NPI 1922614973

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040209000856 NY Part B Supplier - Clinic/Group Practice 9931010485 Receives reassigned benefits from 250 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waddington, NY; Philadelphia, NY; Ogdensburg, NY; Heuvelton, NY; Hammond, NY; Carthage, NY; Canton, NY; Madrid, NY
O20231228000748 NY Part a Provider - Rural Health Clinic 9931010485 Practice locations: Waddington, NY

National Provider Directory

Tax ID family
Carthage Area Hosp (32 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

4 Montgomery HTS
Waddington, NY 13694-7712

Mailing address

1001 West St
Carthage, NY 13619-9703
Phone (315) 519-5724

Other names

  • WADDINGTON HEALTH CENTER Doing business as

Other providers in Waddington, NY

All providers in Waddington, NY · Rural Health Clinic/Center in New York

Sources for this page

Verify at the official NPI Registry.