Provider Demographics
NPI:1801509013
Name:J C BLAIR MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:J C BLAIR MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JOURDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRISHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-375-6160
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-6160
Mailing Address - Fax:
Practice Address - Street 1:417 SABBATH REST RD
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:814-375-6160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty