Provider Demographics
NPI:1982653176
Name:SHARON REGIONAL HEALTH SYSTEM
Entity Type:Organization
Organization Name:SHARON REGIONAL HEALTH SYSTEM
Other - Org Name:SRHS MERCER FAMILY MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT FOR FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHROBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-983-3815
Mailing Address - Street 1:699 E STATE ST
Mailing Address - Street 2:SRHS MERCER FAMILY MEDICINE CENTER
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2057
Mailing Address - Country:US
Mailing Address - Phone:724-983-3820
Mailing Address - Fax:724-983-3941
Practice Address - Street 1:551 GREENVILLE RD
Practice Address - Street 2:SRHS MERCER FAMILY MEDICINE CENTER
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137-5019
Practice Address - Country:US
Practice Address - Phone:724-662-4155
Practice Address - Fax:724-662-2352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHARON REGIONAL HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-08
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA196601261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000000590051Medicaid
PA1000000590051Medicaid