Healthcare Provider Details

I. General information

NPI: 1316471212
Provider Name (Legal Business Name): TITUSVILLE AREA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 11/29/2017
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

406 W OAK ST
TITUSVILLE PA
16354-1404
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-8963
  • Fax: 814-827-8419
Mailing address:
  • Phone: 814-827-8963
  • Fax: 814-827-8419

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: JILL NEELY
Title or Position: CFO
Credential:
Phone: 814-827-1851