1437259611 NPI number — PUNXSUTAWNEY AREA HOSPITAL INC

Table of content: (NPI 1437259611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437259611 NPI number — PUNXSUTAWNEY AREA HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUNXSUTAWNEY AREA 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:
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:
1437259611
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
602 E MAHONING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PUNXSUTAWNEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15767-2316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-938-2431
Provider Business Mailing Address Fax Number:
814-939-1981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
602 E MAHONING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PUNXSUTAWNEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15767-2316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-938-2431
Provider Business Practice Location Address Fax Number:
814-939-1981
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SISK
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
814-938-1882

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  709605 , 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: 1027345 . This is a "GATEWAY MEDICAID HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0745 . This is a "HIGHMARK BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 300145 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007712640018 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007712640059 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007712640020 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 101325 . This is a "UNISON HEALTH MEDICAID HM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 347953 . This is a "HEALTH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007712640058 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P008308 . This is a "CHAMPUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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