Provider Demographics
NPI:1619042827
Name:ALIQUIPPA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:ALIQUIPPA COMMUNITY HOSPITAL
Other - Org Name:ALIQUIPPA COMMUNITY HOSPITAL ANES GRP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FELTS
Authorized Official - Suffix:JR
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:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012601367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1320067OtherHIGHMARK
PA256036OtherHEALTH AMER ASSURANCE
PA1320067OtherHIGHMARK