Provider Demographics
NPI:1912905548
Name:MONONGAHELA VALLEY HOSPITAL, INC.
Entity type:Organization
Organization Name:MONONGAHELA VALLEY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
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 1:1163 COUNTRY CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1095
Mailing Address - Country:US
Mailing Address - Phone:724-258-1160
Mailing Address - Fax:724-258-1394
Practice Address - Street 1:1163 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1095
Practice Address - Country:US
Practice Address - Phone:724-258-1160
Practice Address - Fax:724-258-1394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-08
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
276400000X, 332B00000X
PA137001282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0004405OtherUNITED MINE WORKERS
OH0284437OtherMEDICAID OHIO
PA0728500OtherUNITED MINE WORKERS
PA10073887Medicaid
PA142408OtherHEALTH AMERICA HEALTH ASSURANCE
CA5486926OtherMEDICAID CALIFORNIA IP
PA56053OtherUNISON
PA092OtherHIGHMARK BLUE CROSS
PA0009520OtherAETNA
AL142852OtherMEDICAID ARIZONA
PA918OtherHIGHMARK BLUE CROSS- PSYC
NY00744078OtherMEDICAID NEW YORK
WV0171067000OtherUNISYS
PA1000215OtherGATEWAY HEALTH PLAN
PA1477477OtherUNITED MINE WORKERS
PA390147OtherMEDICARE ID-LEGACY
PA961OtherHIGHMARK BLUE CROSS-REHAB
PAA139133OtherMULTI PLAN
PA103545OtherUPMC
CA6466926OtherMEDICAID CALIFORNIA -OP
NC3900147OtherMEDICAID NORTH CAROLINA
AL142852OtherMEDICAID ARIZONA
CA5486926OtherMEDICAID CALIFORNIA IP
PA56053OtherUNISON
PA918OtherHIGHMARK BLUE CROSS- PSYC