MEDICARE: CONEMAUGH HEALTH INITIATIVES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CB9772	OTHER	PA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1649383951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONEMAUGH HEALTH INITIATIVES

Provider Business Mailing Address
First Line	:	1086 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-4305
Country	:	US
Telephone Number	:	814-410-8300
Fax Number	:	814-410-8331

Provider Business Practice Location Address
First Line	:	3670 PORTAGE STREET
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15946
Country	:	US
Telephone Number	:	814-736-9614
Fax Number	:	814-736-9783

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ELAINE M. LAMBERT
Credential	:
Telephone Number	:	814-534-1630

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	04/21/2010

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Directions to “CONEMAUGH HEALTH INITIATIVES ” Practice Location

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