Provider Demographics
NPI:1689620411
Name:WINDBER HOSPITAL, INC.
Entity Type:Organization
Organization Name:WINDBER HOSPITAL, INC.
Other - Org Name:WINDBER GYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-467-3702
Mailing Address - Street 1:600 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-1331
Mailing Address - Country:US
Mailing Address - Phone:814-467-3176
Mailing Address - Fax:814-467-3177
Practice Address - Street 1:600 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1331
Practice Address - Country:US
Practice Address - Phone:814-467-3176
Practice Address - Fax:814-467-3177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDBER HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-25
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069166L207V00000X
PAMD030628E207V00000X
PAMD036686L207V00000X
PAMD441571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1766853OtherHIGHMARK
PA1007703740027Medicaid
PA1766853OtherHIGHMARK