Healthcare Provider Details

I. General information

NPI: 1740651900
Provider Name (Legal Business Name): TYRONE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
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
16686-1898
US

V. Phone/Fax

Practice location:
  • Phone: 814-684-1255
  • Fax: 814-684-6395
Mailing address:
  • Phone: 814-684-6375
  • Fax: 814-682-1823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number46030101
License Number StatePA

VIII. Authorized Official

Name: ANNA N ANNA
Title or Position: CEO
Credential:
Phone: 814-684-1255