1053352666 NPI number — SHARON REGIONAL HEALTH SYSTEM

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053352666 NPI number — SHARON REGIONAL HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHARON REGIONAL HEALTH SYSTEM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SRHS TRANSITIONAL CARE UNIT
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053352666
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
699 E STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHARON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16146-2057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-983-3817
Provider Business Mailing Address Fax Number:
724-983-3941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
740 E STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16146-3328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-983-3892
Provider Business Practice Location Address Fax Number:
724-983-5690
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHROBAK
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
A
Authorized Official Title or Position:
VICE PRESIDENT, FINANCE
Authorized Official Telephone Number:
724-938-3815

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  196602 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000156719 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0484 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".




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