Provider Demographics
NPI:1639138142
Name:CROWN HEALTH CARE PA
Entity Type:Organization
Organization Name:CROWN HEALTH CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-465-9730
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:305 1ST STREET EAST
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-0249
Mailing Address - Country:US
Mailing Address - Phone:828-465-9730
Mailing Address - Fax:828-465-9293
Practice Address - Street 1:305 1ST ST E
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-1715
Practice Address - Country:US
Practice Address - Phone:828-465-9730
Practice Address - Fax:828-465-9293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCN8132OtherMEDICARE RAILROAD