Healthcare Provider Details

I. General information

NPI: 1326427196
Provider Name (Legal Business Name): ELK REGIONAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 JOHNSONBURG RD
SAINT MARYS PA
15857-3417
US

IV. Provider business mailing address

763 JOHNSONBURG RD
SAINT MARYS PA
15857-3417
US

V. Phone/Fax

Practice location:
  • Phone: 800-446-5090
  • Fax: 814-339-6165
Mailing address:
  • Phone: 814-375-4200
  • Fax: 814-375-4232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY JOSEPH CHAPMAN
Title or Position: PRES/AUTH OFFICIAL
Credential:
Phone: 814-788-8550