Provider Demographics
NPI:1528775269
Name:PUNXSUTAWNEY AREA HOSPITAL INC
Entity type:Organization
Organization Name:PUNXSUTAWNEY AREA HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-938-1886
Mailing Address - Street 1:81 HILLCREST DRIVE
Mailing Address - Street 2:SUITES 100, 200 AND 2200
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2605
Mailing Address - Country:US
Mailing Address - Phone:814-938-7066
Mailing Address - Fax:814-938-4509
Practice Address - Street 1:81 HILLCREST DRIVE
Practice Address - Street 2:STE 100, 200 AND 2200
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-938-7066
Practice Address - Fax:814-938-4509
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PUNXSUTAWNEY AREA HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-02
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100771260072Medicaid