Provider Demographics
NPI:1932500154
Name:DLP CONEMAUGH MEYERSDALE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DLP CONEMAUGH MEYERSDALE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:202 BEACHLEY ST
Mailing Address - Street 2:
Mailing Address - City:MEYERSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15552-1220
Mailing Address - Country:US
Mailing Address - Phone:814-634-5935
Mailing Address - Fax:814-634-9140
Practice Address - Street 1:202 BEACHLEY ST
Practice Address - Street 2:
Practice Address - City:MEYERSDALE
Practice Address - State:PA
Practice Address - Zip Code:15552-1220
Practice Address - Country:US
Practice Address - Phone:814-634-5935
Practice Address - Fax:814-634-9140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-07
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty