Provider Demographics
NPI:1407573769
Name:TYRONE HOSPITAL
Entity Type:Organization
Organization Name:TYRONE HOSPITAL
Other - Org Name:PENN HIGHLANDS ORTHOPEDICS & SPORTS MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL, CEO
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:HALSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-768-2497
Mailing Address - Street 1:187 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1808
Mailing Address - Country:US
Mailing Address - Phone:814-684-1255
Mailing Address - Fax:814-684-6398
Practice Address - Street 1:154 HOSPITAL DR STE 3
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1829
Practice Address - Country:US
Practice Address - Phone:814-684-6347
Practice Address - Fax:814-684-6346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-26
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100773400Medicaid