Provider Demographics
NPI:1780622621
Name:PINECROFT MEDICAL CENTER
Entity type:Organization
Organization Name:PINECROFT MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-684-1255
Mailing Address - Street 1:187 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1808
Mailing Address - Country:US
Mailing Address - Phone:814-684-1255
Mailing Address - Fax:814-684-6398
Practice Address - Street 1:417 SABBATH REST RD STE 3
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-7567
Practice Address - Country:US
Practice Address - Phone:814-940-8195
Practice Address - Fax:814-940-8816
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TYRONE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty