Healthcare Provider Details

I. General information

NPI: 1083762876
Provider Name (Legal Business Name): BROOKVILLE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 INDUSTRIAL PARK RD
BROOKVILLE PA
15825-7228
US

IV. Provider business mailing address

100 HOSPITAL RD
BROOKVILLE PA
15825-1367
US

V. Phone/Fax

Practice location:
  • Phone: 814-849-0990
  • Fax: 814-849-0992
Mailing address:
  • Phone: 814-849-2312
  • Fax: 814-849-1493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIANNE PEER
Title or Position: PRESIDENT/AUTHORIZED OFFICIAL
Credential:
Phone: 814-849-1461