Provider Demographics
NPI:1942396049
Name:EXCELA HEALTH-INCWELL
Entity Type:Organization
Organization Name:EXCELA HEALTH-INCWELL
Other - Org Name:INCWELL (LATROBE AREA HOSPITAL)
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP, PHYS SERV & EXEC DIR, EHPP
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-830-8500
Mailing Address - Street 1:200 VILLAGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3783
Mailing Address - Country:US
Mailing Address - Phone:724-837-9207
Mailing Address - Fax:724-836-4274
Practice Address - Street 1:200 VILLAGE DR STE A
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3783
Practice Address - Country:US
Practice Address - Phone:724-837-9207
Practice Address - Fax:724-836-4274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCELA HEALTH PHYSICIAN PRACTICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-05
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine