Provider Demographics
NPI:1225255649
Name:PHILIPSBURG AREA HOSPITAL
Entity Type:Organization
Organization Name:PHILIPSBURG AREA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOOMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-342-3800
Mailing Address - Street 1:210 LOCH LOMOND RD
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-1930
Mailing Address - Country:US
Mailing Address - Phone:814-342-3800
Mailing Address - Fax:
Practice Address - Street 1:210 LOCH LOMOND RD
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-1930
Practice Address - Country:US
Practice Address - Phone:814-342-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007628460009Medicaid
PA0330OtherBLUE CROSS OF PA
PA0069OtherBLUE CROSS OF PA
PA105329OtherTRICARE CARE NORTH
PA105329OtherTRICARE CARE NORTH