Provider Demographics
NPI:1861660631
Name:ARMSTRONG COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ARMSTRONG COUNTY MEMORIAL HOSPITAL
Other - Org Name:ACMH UROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR PHYSICIAN SERVIC
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRUDGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-543-8670
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-0579
Mailing Address - Country:US
Mailing Address - Phone:724-543-8160
Mailing Address - Fax:
Practice Address - Street 1:400 MEDICAL ARTS BLDG
Practice Address - Street 2:SUITE 410
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7160
Practice Address - Country:US
Practice Address - Phone:724-543-4046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARMSTRONG COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005296Medicare Oscar/Certification