Healthcare Provider Details

I. General information

NPI: 1811398076
Provider Name (Legal Business Name): DLP CONEMAUGH MINER'S MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 HAIDA AVE
HASTINGS PA
16646-5610
US

IV. Provider business mailing address

290 HAIDA AVE
HASTINGS PA
16646-5610
US

V. Phone/Fax

Practice location:
  • Phone: 814-475-8700
  • Fax:
Mailing address:
  • Phone: 814-475-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000