1518900968 NPI number — NASON HOSPITAL

Table of content: (NPI 1518900968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518900968 NPI number — NASON HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NASON HOSPITAL
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:
NASON PEDIATRICS
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:
1518900968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 NASON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROARING SPRING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16673-1202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-224-6201
Provider Business Mailing Address Fax Number:
814-224-6247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 HILLCREST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROARING SPRING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16673-1211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-224-2555
Provider Business Practice Location Address Fax Number:
814-224-4704
Provider Enumeration Date:
06/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ASKEY
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VICE PRESIDENT, FISCAL SERVICES
Authorized Official Telephone Number:
814-224-6201

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1007464210007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 958913 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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