Provider Demographics
NPI:1417664152
Name:TYRONE HOSPITAL
Entity Type:Organization
Organization Name:TYRONE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JOURDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRISHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-375-6160
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:
Mailing Address - Fax:
Practice Address - Street 1:187 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1808
Practice Address - Country:US
Practice Address - Phone:814-384-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematologyGroup - Multi-Specialty
No246QH0000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHematologyGroup - Multi-Specialty