1922151380 NPI number — WINDBER HOSPITAL, INC

Table of content: (NPI 1922151380)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922151380 NPI number — WINDBER HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINDBER HOSPITAL, INC
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:
WINDBER HOSPICE
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:
1922151380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 SOMERSET AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDBER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15963-1331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-467-3000
Provider Business Mailing Address Fax Number:
814-467-3407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 SOMERSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDBER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15963-1331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-467-3000
Provider Business Practice Location Address Fax Number:
814-467-3407
Provider Enumeration Date:
01/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KURTZ
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
814-467-3703

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  154199 , 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: 1012 . This is a "HIGHMARK BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007703740008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".