Provider Demographics
NPI:1740604776
Name:CLEARFIELD HOSPITAL (DBA PENN HIGHLANDS CLEARFIELD EFF 7/01/14)
Entity Type:Organization
Organization Name:CLEARFIELD HOSPITAL (DBA PENN HIGHLANDS CLEARFIELD EFF 7/01/14)
Other - Org Name:PENN HIGHLANDS CLEARFIELD BRIGHT HORIZONS OUTPATIENT (GROUP CLINIC)
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-768-2442
Mailing Address - Street 1:1033 TURNPIKE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3061
Mailing Address - Country:US
Mailing Address - Phone:814-768-2137
Mailing Address - Fax:814-768-2084
Practice Address - Street 1:1033 TURNPIKE AVE
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3061
Practice Address - Country:US
Practice Address - Phone:814-768-2137
Practice Address - Fax:814-768-2084
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEARFIELD HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-11
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes273R00000XHospital UnitsPsychiatric Unit
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA400673Medicare PIN