Provider Demographics
NPI:1326240979
Name:CONEMAUGH HEALTH COMPANY LLC
Entity Type:Organization
Organization Name:CONEMAUGH HEALTH COMPANY LLC
Other - Org Name:CONEMAUGH HOME MEDICAL COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLENE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-534-4430
Mailing Address - Street 1:331 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901
Mailing Address - Country:US
Mailing Address - Phone:814-534-4430
Mailing Address - Fax:814-534-4477
Practice Address - Street 1:331 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-2541
Practice Address - Country:US
Practice Address - Phone:814-534-4430
Practice Address - Fax:814-534-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8000001322332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10146877701Medicaid
PA10146877701Medicaid