Healthcare Provider Details

I. General information

NPI: 1588062814
Provider Name (Legal Business Name): UPMC ALTOONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2014
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 WASHINGTON ST
HUNTINGDON PA
16652-1726
US

IV. Provider business mailing address

814 WASHINGTON ST
HUNTINGDON PA
16652-1726
US

V. Phone/Fax

Practice location:
  • Phone: 814-643-4415
  • Fax: 814-643-2620
Mailing address:
  • Phone: 814-643-4415
  • Fax: 814-643-2620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARK EHALT
Title or Position: DIRECTOR
Credential:
Phone: 412-647-0943