Provider Demographics
NPI:1902972136
Name:ERIE CENTER ON HEALTH & AGING, INC.
Entity Type:Organization
Organization Name:ERIE CENTER ON HEALTH & AGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-453-5072
Mailing Address - Street 1:406 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1417
Mailing Address - Country:US
Mailing Address - Phone:814-453-5072
Mailing Address - Fax:814-459-4744
Practice Address - Street 1:406 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1417
Practice Address - Country:US
Practice Address - Phone:814-453-5072
Practice Address - Fax:814-459-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center