Provider Demographics
NPI:1801897038
Name:DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Entity type:Organization
Organization Name:DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7688
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4536
Mailing Address - Country:US
Mailing Address - Phone:615-920-7000
Mailing Address - Fax:615-920-8913
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-534-9000
Practice Address - Fax:814-539-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA035601282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103577OtherUPMC GENERAL HOSPITAL
PA30014300OtherFEDERAL BLACK LUNG PROGRA
PA250965307OtherCOMMERCIAL GENERAL HOSPIT
PA0033OtherBLUE CROSS GENERAL HOSP
PA1007568490052Medicaid
PA60573OtherUNISON GENRAL HOSPITAL
PA1004907OtherGATEWAY GENERAL HOSP
PA119651801OtherFEDERAL WORKERS COMPENSAT
PA390110Medicare ID - Type UnspecifiedCONEMAUGH VALLEY MEMORIAL