Provider Demographics
NPI:1659663565
Name:ST. BARNABAS MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:ST. BARNABAS MEDICAL CENTER, INC
Other - Org Name:ST. BARNABAS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-443-7231
Mailing Address - Street 1:5830 MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9668
Mailing Address - Country:US
Mailing Address - Phone:724-443-7231
Mailing Address - Fax:
Practice Address - Street 1:5060 TUSCARAWAS RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1006
Practice Address - Country:US
Practice Address - Phone:724-495-3350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. BARNABAS MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-11
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021853L332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6525130001Medicare NSC