Healthcare Provider Details

I. General information

NPI: 1417331554
Provider Name (Legal Business Name): BROOKVILLE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2015
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 RAILROAD ST
PHILIPSBURG PA
16866-2300
US

IV. Provider business mailing address

100 HOSPITAL RD
BROOKVILLE PA
15825-1367
US

V. Phone/Fax

Practice location:
  • Phone: 814-342-9701
  • Fax: 814-342-7506
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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 Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIANNE PEER
Title or Position: PRESIDENT, AUTHORIZED OFFICIAL
Credential:
Phone: 814-849-1461