Healthcare Provider Details

I. General information

NPI: 1124729264
Provider Name (Legal Business Name): KEYSTONE RURAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 MARKET SQUARE BLVD
WAYNESBORO PA
17268-3811
US

IV. Provider business mailing address

111 CHAMBERS HILL DR STE 200
CHAMBERSBURG PA
17201-7304
US

V. Phone/Fax

Practice location:
  • Phone: 717-762-6300
  • Fax: 717-762-1831
Mailing address:
  • Phone: 717-709-7922
  • Fax: 717-263-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: JOANNE COCHRAN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 717-709-7906