Healthcare Provider Details
I. General information
NPI: 1598842627
Provider Name (Legal Business Name): DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US
IV. Provider business mailing address
330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-4536
US
V. Phone/Fax
- Phone: 814-534-1821
- Fax: 814-534-1743
- Phone: 615-920-7000
- Fax: 615-920-8913
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLOTTE
LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000