Provider Demographics
NPI:1962444729
Name:WARREN GENERAL HOSPITAL
Entity Type:Organization
Organization Name:WARREN GENERAL HOSPITAL
Other - Org Name:CANCER CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC DIR FISCAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-723-3300
Mailing Address - Street 1:2 CRESCENT PARK WEST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2111
Mailing Address - Country:US
Mailing Address - Phone:814-723-3300
Mailing Address - Fax:814-723-8515
Practice Address - Street 1:105 LEE STREET
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2114
Practice Address - Country:US
Practice Address - Phone:814-726-1786
Practice Address - Fax:814-723-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA490401207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA56609OtherUNISON
PA1423929OtherHIGHMARK BCBS
PA1423929OtherHIGHMARK BCBS