Provider Demographics
NPI:1871827311
Name:TYRONE HOSPITAL
Entity Type:Organization
Organization Name:TYRONE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-684-1255
Mailing Address - Street 1:187 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1808
Mailing Address - Country:US
Mailing Address - Phone:814-684-6301
Mailing Address - Fax:814-682-1820
Practice Address - Street 1:187 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1808
Practice Address - Country:US
Practice Address - Phone:814-684-1255
Practice Address - Fax:814-684-6395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA46030101282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007734000002Medicaid
PA403044Medicare Oscar/Certification