1275646101 NPI number — SHARON REGIONAL HEALTH SYSTEM

Table of content: (NPI 1275646101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275646101 NPI number — SHARON REGIONAL HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHARON REGIONAL HEALTH SYSTEM
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:
6
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:
1275646101
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:
699 E STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHARON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16146-2057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-983-3817
Provider Business Mailing Address Fax Number:
724-983-3941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
551 GREENVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16137-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-983-4155
Provider Business Practice Location Address Fax Number:
724-983-3836
Provider Enumeration Date:
08/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAUER
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
W
Authorized Official Title or Position:
VICE PRESIDENT FOR FINANCE
Authorized Official Telephone Number:
724-983-3815

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  404840 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QM0855X , with the licence number: 404840 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 1000000590063 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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