Provider Demographics
NPI:1629471768
Name:DLP CONEMAUGH MINERS MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DLP CONEMAUGH MINERS MEDICAL CENTER LLC
Other - Org Name:MINERS HOSPITAL EMERGENCY PHYSICIAN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:290 HAIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16646-5610
Mailing Address - Country:US
Mailing Address - Phone:814-269-3100
Mailing Address - Fax:
Practice Address - Street 1:290 HAIDA AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:PA
Practice Address - Zip Code:16646-5610
Practice Address - Country:US
Practice Address - Phone:814-269-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty