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Carthage Area Hospital Inc

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

NPI 1982815445 · NPPES record last updated May 5, 2021

Key facts

NPI
1982815445
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CARTHAGE AREA HOSPITAL INC
Practice address
36500 State Route 26
Carthage, NY 13619-9506
Phone
(315) 493-5080
NPI assigned
May 25, 2007
Organization subpart
No

Authorized official

Name
Richard Duvall
Title
Ceo
Phone
(315) 519-5201

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 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.

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 in NY

Rural health clinic certification: CCN 333986

Legal name
CARTHAGE AREA HOSPITAL INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 26, 2019
Last certification
Jul 16, 2025
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Jun 1, 1965 in NY
Enrollment address
36500 State Route 26
Carthage, NY 13619-9506
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		 May 1, 2010
Andrew R Manzer
Individual 		Corporate Officer
Interim Ceo		 Mar 2, 2026
W-2 Managing Employee 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		 May 1, 1992
Tim Sturick
Individual 		Corporate Director
Treasurer of Board		 May 1, 2016
Gary Rowe
Individual 		Corporate Director
President of Board		 May 1, 2007
Larry Hasseler
Individual 		Corporate Director
Secretary of Board		 May 1, 2006

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20181220000701 NY Part a Provider - Rural Health Clinic 9931010485 Practice locations: Carthage, NY

National Provider Directory

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

Locations

36500 State Route 26
Carthage, NY 13619
Phone (315) 493-5030

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 2238001H NY
Primary Care Clinic/Center 261QP2300X 2238001H NY
Rural Health Clinic/Center 261QR1300X Yes
Student Health Clinic/Center 261QS1000X 2238001H NY

Addresses

Primary practice location

36500 State Route 26
Carthage, NY 13619-9506

Mailing address

1001 West St
Carthage, NY 13619-9703
Phone (315) 493-1000

Other identifiers

IdentifierTypeStateIssuer
03000768MedicaidNY

Other providers in Carthage, NY

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

Sources for this page

Verify at the official NPI Registry.