Provider Demographics
NPI:1922025436
Name:LATROBE AREA HOSPITAL
Entity Type:Organization
Organization Name:LATROBE AREA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-832-4030
Mailing Address - Street 1:PO BOX 1100
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5011
Mailing Address - Country:US
Mailing Address - Phone:724-537-1000
Mailing Address - Fax:724-832-4468
Practice Address - Street 1:ONE MELLON WAY
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1046
Practice Address - Country:US
Practice Address - Phone:724-537-1000
Practice Address - Fax:724-832-4468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA122601261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0913OtherHIGHMARK BCBS
PA1007610520006Medicaid
390219Medicare PIN
390219Medicare ID - Type Unspecified