Provider Demographics
NPI:1265449870
Name:PUNXSUTAWNEY AREA HOSPITAL INC
Entity Type:Organization
Organization Name:PUNXSUTAWNEY AREA HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:G
Authorized Official - Last Name:SISK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-938-1882
Mailing Address - Street 1:81 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2605
Mailing Address - Country:US
Mailing Address - Phone:814-938-1800
Mailing Address - Fax:814-938-1885
Practice Address - Street 1:81 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-938-1800
Practice Address - Fax:814-938-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA163701282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007712640007Medicaid
PA1011417OtherMEDICAID HMO GATEWAY HEAL
PA105192OtherUPMC HEALTH PLAN
PA192446OtherHEALTH AMERICA HEALTH ASR
PA60627OtherMCD HMO UNISON HEALTH PL
PA056069OtherUNISON HEALTH PLAN MCD HM
PA063945OtherMEDICARE SURGICAL ASSIST
PA1007712640047Medicaid
PA300145OtherFEDERAL BLACK LUNG
PA0064OtherHIGHMARK BLUE CROSS
PA063945OtherMEDICARE SUR ASSIST
PA1034443OtherEMERGENCY ROOM GATEWAY
PA1034443OtherEMERGENCY ROOM GATEWAY
PA=========007OtherTRICARE
PA390199Medicare ID - Type Unspecified
PA60627OtherMCD HMO UNISON HEALTH PL