Healthcare Provider Details

I. General information

NPI: 1780883181
Provider Name (Legal Business Name): DLP CONEMAUGH PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 08/04/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 SCALP AVE
JOHNSTOWN PA
15904-3339
US

IV. Provider business mailing address

1450 SCALP AVE
JOHNSTOWN PA
15904-3339
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-3399
  • Fax: 814-534-1088
Mailing address:
  • Phone: 814-534-3399
  • Fax: 814-534-1088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP481210
License Number StatePA

VIII. Authorized Official

Name: SIERRA LEE ROBERTS
Title or Position: PHARMACIST IN CHARGE
Credential: PHARM D
Phone: 814-534-3399