Provider Demographics
NPI:1093716060
Name:MONSOUR MEDICAL CENTER
Entity Type:Organization
Organization Name:MONSOUR MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAMINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-527-0604
Mailing Address - Street 1:70 LINCOLN HWY E
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3141
Mailing Address - Country:US
Mailing Address - Phone:724-527-1511
Mailing Address - Fax:
Practice Address - Street 1:70 LINCOLN HWY E
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3141
Practice Address - Country:US
Practice Address - Phone:724-526-1511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA136501282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
0976OtherB. CROSS
205331OtherUPMC
25179OtherCOMMUNITY CARE
333690OtherVBH
56148OtherMED PLUS
0124OtherB. CROSS
333690OtherVALUE OPTIONS
1132OtherB. CROSS
154215OtherMED PLUS
326993AOtherVBH
326993AOtherVALUE OPTIONS
679835OtherB. CROSS
0147OtherB. CROSS
PA7102000 PA 15644OtherBCOFMI
1006210OtherGATEWAY
56142OtherMED PLUS
154215OtherMED PLUS
326993AOtherVALUE OPTIONS
333690OtherVALUE OPTIONS