Healthcare Provider Details

I. General information

NPI: 1609493790
Provider Name (Legal Business Name): J C BLAIR MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 COLONNADE BLVD
STATE COLLEGE PA
16803-2668
US

IV. Provider business mailing address

1225 WARM SPRINGS AVE
HUNTINGDON PA
16652-2398
US

V. Phone/Fax

Practice location:
  • Phone: 814-643-8485
  • Fax:
Mailing address:
  • Phone: 814-643-8295
  • Fax: 814-643-7021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier100768376
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier075036
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGROUP PTAN

VIII. Authorized Official

Name: JOURDAN STRISHOCK
Title or Position: COMPLIANCE
Credential:
Phone: 814-375-6160