Provider Demographics
NPI:1710265939
Name:HYNDMAN AREA HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:HYNDMAN AREA HEALTH CENTER, INC.
Other - Org Name:BEDFORD FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTYCZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-263-5804
Mailing Address - Street 1:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:HYNDMAN
Mailing Address - State:PA
Mailing Address - Zip Code:15545-0706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-1013
Practice Address - Country:US
Practice Address - Phone:814-263-5804
Practice Address - Fax:814-310-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
391977Medicare Oscar/Certification