Provider Demographics
NPI:1134948953
Name:HUGHES MEMORIAL, LLC
Entity type:Organization
Organization Name:HUGHES MEMORIAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLWAGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-480-2475
Mailing Address - Street 1:10 SHORTY LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-2654
Mailing Address - Country:US
Mailing Address - Phone:724-480-2502
Mailing Address - Fax:
Practice Address - Street 1:10 SHORTY LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-2654
Practice Address - Country:US
Practice Address - Phone:724-480-2502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty