Provider Demographics
NPI:1811948276
Name:GGNSC UNIONTOWN LP
Entity type:Organization
Organization Name:GGNSC UNIONTOWN LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SEC. OF THE GP
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:129 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5048
Mailing Address - Country:US
Mailing Address - Phone:724-439-5700
Mailing Address - Fax:724-439-8039
Practice Address - Street 1:129 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5048
Practice Address - Country:US
Practice Address - Phone:724-439-5700
Practice Address - Fax:724-439-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA062802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0598OtherHIGHMARK WESTERN PA
PA217523OtherUPMC
PA119466OtherHEALTH AMERICA
PA1508551OtherGATEWAY HEALTH PLAN
PA000000087014OtherTHREE RIVERS HEALTH PLAN
PA101558293Medicaid
PA1015582930001Medicaid
PA000000087014OtherTHREE RIVERS HEALTH PLAN
PA1508551OtherGATEWAY HEALTH PLAN