Provider Demographics
NPI:1770916603
Name:PENN STATE ALTOONA HEALTH AND WELLNESS CENTER
Entity type:Organization
Organization Name:PENN STATE ALTOONA HEALTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROCUREMENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-863-0274
Mailing Address - Street 1:3000 IVYSIDE PARK
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-3777
Mailing Address - Country:US
Mailing Address - Phone:814-949-5540
Mailing Address - Fax:
Practice Address - Street 1:3000 IVYSIDE PARK
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3777
Practice Address - Country:US
Practice Address - Phone:814-949-5540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE PENNSYLVANIA STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health