Provider Demographics
NPI:1578648473
Name:ALIQUIPPA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:ALIQUIPPA COMMUNITY HOSPITAL
Other - Org Name:ACH ER PHYSICIAN
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FELTS
Authorized Official - Suffix:IX
Authorized Official - Credentials:
Authorized Official - Phone:724-857-1711
Mailing Address - Street 1:2500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2123
Mailing Address - Country:US
Mailing Address - Phone:724-857-1212
Mailing Address - Fax:724-857-1298
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2123
Practice Address - Country:US
Practice Address - Phone:724-857-1212
Practice Address - Fax:724-857-1298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012601207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACOVENTRYOther256032
PA1325099OtherHIGHMARK
PA062301Medicare ID - Type Unspecified