1447443957 NPI number — HIGHLANDS HOSPITAL AND HEALTH CENTER

Table of content: (NPI 1447443957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447443957 NPI number — HIGHLANDS HOSPITAL AND HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGHLANDS HOSPITAL AND HEALTH CENTER
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:
HIGHLANDS HOSPITAL PHYSICIANS
Provider Other Organization Name Type Code:
3
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:
1447443957
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 E MURPHY AVE
Provider Second Line Business Mailing Address:
P.O. BOX 1004
Provider Business Mailing Address City Name:
CONNELLSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-628-1500
Provider Business Mailing Address Fax Number:
724-626-2334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 E MURPHY AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
CONNELLSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-628-1500
Provider Business Practice Location Address Fax Number:
724-626-2334
Provider Enumeration Date:
08/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ANDURSKY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
724-628-1500

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: OS013321 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 100776921 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1774039 . This is a "HIGHMARK BC/BS GRP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CD5179 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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