Provider Demographics
NPI:1902987878
Name:MONONGAHELA VALLEY HOSPITAL INC
Entity Type:Organization
Organization Name:MONONGAHELA VALLEY HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-258-1000
Mailing Address - Street 1:1163 COUNTRY CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1095
Mailing Address - Country:US
Mailing Address - Phone:724-258-1085
Mailing Address - Fax:724-258-1394
Practice Address - Street 1:1163 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1095
Practice Address - Country:US
Practice Address - Phone:724-258-1085
Practice Address - Fax:724-258-1394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA137001282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1428557OtherDR DEAN ORNISH PROGRAM