Provider Demographics
NPI:1134121387
Name:ALIQUIPPA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:ALIQUIPPA COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FELTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:724-857-1212
Mailing Address - Street 1:2500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2123
Mailing Address - Country:US
Mailing Address - Phone:724-857-1212
Mailing Address - Fax:724-857-1298
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2123
Practice Address - Country:US
Practice Address - Phone:724-857-1212
Practice Address - Fax:724-857-1298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012601261QA1903X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007403570011Medicaid
PA60222OtherTHREE RIVERS HEALTH PLAN
PA019101OtherVALUE BEHAVIORAL HEALTH
PA111618OtherHEALTH AMERICA/HEALTH ASSURANCE
PAV0H048OtherUPMC HEALTH PLAN
PA0400OtherBC PSYCH PROV NO
PA1007403570061Medicaid
PA80000OtherAETNA/USHC PROV NO
PA0512OtherBC SNF PROV NO
PA1007403570039Medicaid
PA0122OtherBC ACUTE PROV NO
PA1005242OtherGATEWAY HEALTH PLAN
PA019101OtherVALUE BEHAVIORAL HEALTH
PA0122OtherBC ACUTE PROV NO