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	MD052898L	PA

General Provider Information

NPI Number	:	1902901390
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	:	814-535-8885
Fax Number	:	814-255-2961

Provider Business Practice Location Address
First Line	:	1100 W HIGH ST
Second Line	:
City	:	EBENSBURG
State	:	PA
Zip	:	15931-1706
Country	:	US
Telephone Number	:	814-472-7933
Fax Number	:	814-472-2301

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/22/2020

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