Healthcare Provider Details

I. General information

NPI: 1760471551
Provider Name (Legal Business Name): WARREN GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TWO CRESCENT PARK W
WARREN PA
16365-0068
US

IV. Provider business mailing address

2 CRESCENT PARK WEST
WARREN PA
16365-2111
US

V. Phone/Fax

Practice location:
  • Phone: 814-723-4973
  • Fax: 814-723-8515
Mailing address:
  • Phone: 814-723-3300
  • Fax: 814-723-8515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number709205
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE SNYDER
Title or Position: EXEC DIRECTOR OF FISCAL SERVICES
Credential:
Phone: 814-723-3300