1427022078 NPI number — CLEARFIELD HOSPITAL

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 1427022078 NPI number — CLEARFIELD HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEARFIELD 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:
Provider Other Organization Name Type Code:
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:
1427022078
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
809 TURNPIKE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARFIELD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16830-1232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-765-5341
Provider Business Mailing Address Fax Number:
814-768-2344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
809 TURNPIKE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16830-1232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-765-5341
Provider Business Practice Location Address Fax Number:
814-768-2344
Provider Enumeration Date:
02/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
DANETTE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
814-768-2448

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  291301 , 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: 105083 . This is a "UPMC PROV #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 390052 . This is a "PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 030162400 . This is a "FED BLACK LUNG PROV #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20024 . This is a "GEISINGER PROV #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0066 . This is a "HIGHMARK BC PROV #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100747400-0032 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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