Provider Demographics
NPI:1730186206
Name:BUTLER MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:BUTLER MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, NETWORK BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-284-4467
Mailing Address - Street 1:911 E BRADY ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4646
Mailing Address - Country:US
Mailing Address - Phone:724-284-4467
Mailing Address - Fax:724-284-4095
Practice Address - Street 1:911 E BRADY ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4646
Practice Address - Country:US
Practice Address - Phone:724-284-4467
Practice Address - Fax:724-284-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA023701282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000037228Medicaid
SD0125030Medicaid
WA3019957Medicaid
OH1195880Medicaid
MI1821976Medicaid
CAXHSP32594 XHSP42594Medicaid
NJ0028932Medicaid
NY00979924Medicaid
PA0173400000Medicaid
PA1061194Medicaid
VTBU0390168Medicaid
NH20001901Medicaid
IA0950634Medicaid
PA20008045Medicaid
MI1821976Medicaid
WI=========Medicaid