Provider Demographics
NPI:1477822716
Name:CLARION HOSPITAL DIAGNOSIS & REHAB
Entity Type:Organization
Organization Name:CLARION HOSPITAL DIAGNOSIS & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMORELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-226-1301
Mailing Address - Street 1:1 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8501
Mailing Address - Country:US
Mailing Address - Phone:814-226-9500
Mailing Address - Fax:814-226-1457
Practice Address - Street 1:24 DOCTORS LN STE 104
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8568
Practice Address - Country:US
Practice Address - Phone:814-226-9500
Practice Address - Fax:814-226-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA297801261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1002337670039Medicaid