Healthcare Provider Details

I. General information

NPI: 1255349981
Provider Name (Legal Business Name): TITUSVILLE AREA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 W OAK ST
TITUSVILLE PA
16354-1404
US

IV. Provider business mailing address

335 W OAK ST
TITUSVILLE PA
16354-1416
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-9770
  • Fax: 814-827-3556
Mailing address:
  • Phone: 814-827-1852
  • Fax: 814-827-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD440393
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JILL A NEELY
Title or Position: CFO
Credential: CFO
Phone: 814-827-1852