Provider Demographics
NPI:1740774207
Name:TITUSVILLE AREA HOSPITAL
Entity Type:Organization
Organization Name:TITUSVILLE AREA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURDICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-827-8963
Mailing Address - Street 1:406 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-1404
Mailing Address - Country:US
Mailing Address - Phone:814-827-1852
Mailing Address - Fax:814-827-3099
Practice Address - Street 1:339 W SPRING ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1655
Practice Address - Country:US
Practice Address - Phone:814-827-9675
Practice Address - Fax:814-827-0216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TITUSVILLE AREA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health