Healthcare Provider Details

I. General information

NPI: 1457354672
Provider Name (Legal Business Name): DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 LOCUST ST FIRST FLOOR SUITE
JOHNSTOWN PA
15901-1651
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-4536
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-7500
  • Fax: 814-534-7501
Mailing address:
  • Phone: 615-920-7000
  • Fax: 615-920-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number740605
License Number StatePA

VIII. Authorized Official

Name: VICTOR E. GIOVANETTI
Title or Position: PRESIDENT
Credential:
Phone: 615-920-7000