Healthcare Provider Details

I. General information

NPI: 1962525576
Provider Name (Legal Business Name): EXCELAHEALTH LATROBE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EXCELAHEALTH LATROBE AREA HOSPITAL 121 WEST SECOND AVE.
LATROBE PA
15650-2551
US

IV. Provider business mailing address

EXCELAHEALTH LATROBE AREA HOSPITAL 121 WEST SECOND AVE.
LATROBE PA
15650-2551
US

V. Phone/Fax

Practice location:
  • Phone: 724-537-1000
  • Fax: 724-537-1918
Mailing address:
  • Phone: 724-537-1000
  • Fax: 724-537-1918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW003900L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. PHYLLIS CRATTY
Title or Position: MANAGER
Credential: RN
Phone: 724-537-1000