Provider Demographics
NPI:1265649776
Name:EXCELA HEALTH LATROBE HOSPITAL
Entity Type:Organization
Organization Name:EXCELA HEALTH LATROBE HOSPITAL
Other - Org Name:WOMEN'S CARE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SVIDRON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:724-537-1870
Mailing Address - Street 1:212 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1069
Mailing Address - Country:US
Mailing Address - Phone:724-537-1870
Mailing Address - Fax:724-532-6975
Practice Address - Street 1:212 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1069
Practice Address - Country:US
Practice Address - Phone:724-537-1870
Practice Address - Fax:724-532-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007610520013Medicaid