Healthcare Provider Details

I. General information

NPI: 1225006703
Provider Name (Legal Business Name): BROOKVILLE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 02/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD
BROOKVILLE PA
15825-1367
US

IV. Provider business mailing address

100 HOSPITAL RD
BROOKVILLE PA
15825-1367
US

V. Phone/Fax

Practice location:
  • Phone: 814-849-2312
  • Fax: 814-849-4841
Mailing address:
  • Phone: 814-849-2312
  • Fax: 814-849-4841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number2805
License Number StatePA

VIII. Authorized Official

Name: MS. JULIANNE PEER
Title or Position: PRESIDENT
Credential:
Phone: 814-849-1461