Provider Demographics
NPI:1437259611
Name:PUNXSUTAWNEY AREA HOSPITAL INC
Entity Type:Organization
Organization Name:PUNXSUTAWNEY AREA HOSPITAL INC
Other - Org Name:PUNXSUTAWNEY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:SISK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-938-1882
Mailing Address - Street 1:602 E MAHONING ST
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2316
Mailing Address - Country:US
Mailing Address - Phone:814-938-2431
Mailing Address - Fax:814-939-1981
Practice Address - Street 1:602 E MAHONING ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2316
Practice Address - Country:US
Practice Address - Phone:814-938-2431
Practice Address - Fax:814-939-1981
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PUNXSUTAWNEY AREA HOSPITAL,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-25
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA709605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027345OtherGATEWAY MEDICAID HMO
PA0745OtherHIGHMARK BLUE CROSS
PA300145OtherFEDERAL BLACK LUNG
PA1007712640018Medicaid
PA1007712640059Medicaid
PA1007712640020Medicaid
PA101325OtherUNISON HEALTH MEDICAID HM
PA347953OtherHEALTH ASSURANCE
PA1007712640058Medicaid
PAP008308OtherCHAMPUS
PA1007712640059Medicaid