1801897038 NPI number — DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC

Table of content: (NPI 1801897038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801897038 NPI number — DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
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:
MEMORIAL MEDICAL CENTER
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:
1801897038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 SEVEN SPRINGS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-920-7000
Provider Business Mailing Address Fax Number:
615-920-8913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1086 FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15905-4305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-534-9000
Provider Business Practice Location Address Fax Number:
814-539-0264
Provider Enumeration Date:
08/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DILLON
Authorized Official First Name:
TERRANCE
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
502-596-7220

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  035601 , 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: 30014300 . This is a "FEDERAL BLACK LUNG PROGRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 250965307 . This is a "COMMERCIAL GENERAL HOSPIT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0033 . This is a "BLUE CROSS GENERAL HOSP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1004907 . This is a "GATEWAY GENERAL HOSP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 103577 . This is a "UPMC GENERAL HOSPITAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 60573 . This is a "UNISON GENRAL HOSPITAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007568490052 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119651801 . This is a "FEDERAL WORKERS COMPENSAT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com