Healthcare Provider Details

I. General information

NPI: 1811886575
Provider Name (Legal Business Name): MEADVILLE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S ERIE ST STE E
MERCER PA
16137-1555
US

IV. Provider business mailing address

1034 GROVE ST
MEADVILLE PA
16335-2945
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-4155
  • Fax: 724-662-2352
Mailing address:
  • Phone: 724-662-4155
  • Fax: 724-662-2352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: RENATO SUNTAY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 814-333-5030