Healthcare Provider Details

I. General information

NPI: 1104921428
Provider Name (Legal Business Name): TITUSVILLE AREA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 WEST OAK STREET
TITUSVILLE PA
16354
US

IV. Provider business mailing address

406 WEST OAK STREET
TITUSVILLE PA
16354
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-8923
  • Fax: 814-827-3099
Mailing address:
  • Phone: 814-827-8923
  • Fax: 814-827-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number200901
License Number StatePA

VIII. Authorized Official

Name: JILL A NEELY
Title or Position: CFO
Credential:
Phone: 814-827-8923