Healthcare Provider Details

I. General information

NPI: 1740908300
Provider Name (Legal Business Name): TYRONE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 HOSPITAL DR
TYRONE PA
16686-1808
US

IV. Provider business mailing address

187 HOSPITAL DR
TYRONE PA
16686-1808
US

V. Phone/Fax

Practice location:
  • Phone: 814-684-1255
  • Fax: 814-684-6395
Mailing address:
  • Phone: 814-684-1255
  • Fax: 814-684-6395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: RHONDA FAYE HALSTEAD
Title or Position: PRESIDENT/AUTHORIZED OFFICIAL
Credential:
Phone: 814-768-2497