1033482450 NPI number — CLARION HOSPITAL FAMILY HEALTHCARE

Table of content: (NPI 1033482450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033482450 NPI number — CLARION HOSPITAL FAMILY HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLARION HOSPITAL FAMILY HEALTHCARE
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:
1033482450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARION
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16214-8501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-226-9500
Provider Business Mailing Address Fax Number:
814-226-1457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 DOCTORS LN
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
CLARION
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16214-8568
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-226-2500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LAMORELLA
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
814-226-1301

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  297801 , 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: 100233767 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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