Provider Demographics
NPI:1497852347
Name:WESTMORELAND PRIMARY HEALTH CENTER
Entity Type:Organization
Organization Name:WESTMORELAND PRIMARY HEALTH CENTER
Other - Org Name:CHRISTIAN VITTONE, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-850-8591
Mailing Address - Street 1:210 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1106
Mailing Address - Country:US
Mailing Address - Phone:724-238-2121
Mailing Address - Fax:724-238-4755
Practice Address - Street 1:210 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-1106
Practice Address - Country:US
Practice Address - Phone:724-238-2121
Practice Address - Fax:724-238-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA054053Medicare ID - Type Unspecified