Provider Demographics
NPI:1689612137
Name:HUNTINGDON HEALTHCARE, INC
Entity Type:Organization
Organization Name:HUNTINGDON HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:J
Authorized Official - Last Name:IRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-386-1360
Mailing Address - Street 1:814 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1726
Mailing Address - Country:US
Mailing Address - Phone:814-643-4415
Mailing Address - Fax:814-643-2620
Practice Address - Street 1:814 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1726
Practice Address - Country:US
Practice Address - Phone:814-643-4415
Practice Address - Fax:814-643-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018907590006Medicaid
PA057244Medicare PIN
PA0018907590006Medicaid