MEDICARE: HUNTINGDON HEALTHCARE, INC

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	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689612137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTINGDON HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	814 WASHINGTON ST
Second Line	:
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-1726
Country	:	US
Telephone Number	:	814-643-4415
Fax Number	:	814-643-2620

Provider Business Practice Location Address
First Line	:	814 WASHINGTON ST
Second Line	:
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-1726
Country	:	US
Telephone Number	:	814-643-4415
Fax Number	:	814-643-2620

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	CARLA J. IRVIN
Credential	:
Telephone Number	:	814-386-1360

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	06/02/2011

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