Healthcare Provider Details

I. General information

NPI: 1326509837
Provider Name (Legal Business Name): TITUSVILLE AREA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BRIDGE ST
TIONESTA PA
16353-9737
US

IV. Provider business mailing address

406 W OAK ST
TITUSVILLE PA
16354-1499
US

V. Phone/Fax

Practice location:
  • Phone: 814-755-3631
  • Fax: 814-755-3633
Mailing address:
  • Phone: 814-827-1851
  • Fax: 814-827-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE BURDICK
Title or Position: PRACTICE MANAGER
Credential:
Phone: 814-827-8963