Provider Demographics
NPI:1902972870
Name:HIGHLANDS HOSPITAL
Entity Type:Organization
Organization Name:HIGHLANDS HOSPITAL
Other - Org Name:PENN HIGHLANDS CONNELLSVILLE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:JOURDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRISHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-375-6160
Mailing Address - Street 1:401 E MURPHY AVE
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-2724
Mailing Address - Country:US
Mailing Address - Phone:724-628-1500
Mailing Address - Fax:724-626-2217
Practice Address - Street 1:401 E MURPHY AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-2724
Practice Address - Country:US
Practice Address - Phone:724-628-1500
Practice Address - Fax:724-626-2217
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-24
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA037301282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007769210016Medicaid