Healthcare Provider Details

I. General information

NPI: 1700834314
Provider Name (Legal Business Name): FULTON COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PEACH ORCHARD RD
MC CONNELLSBURG PA
17233-8559
US

IV. Provider business mailing address

214 PEACH ORCHARD RD
MC CONNELLSBURG PA
17233-8559
US

V. Phone/Fax

Practice location:
  • Phone: 717-485-2880
  • Fax: 717-485-6105
Mailing address:
  • Phone: 717-485-2880
  • Fax: 717-485-6105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier395387
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAPITAL BLUE-SKILLED
# 2
Identifier1527
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK- SKILLED

VIII. Authorized Official

Name: KIM MEYERS
Title or Position: REVENUE MANAGER
Credential:
Phone: 717-485-3155