=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295675593
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDIANA REGIONAL MEDICAL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2026
-----------------------------------------------------
Last Update Date | 03/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3840 WILLIAM PENN AVE
-----------------------------------------------------
City | NANTY GLO
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15943-3423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-749-3572
-----------------------------------------------------
Fax | 724-540-4033
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 835 HOSPITAL RD
-----------------------------------------------------
City | INDIANA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15701-3629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-357-7008
-----------------------------------------------------
Fax | 724-723-1516
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR OF REVENUE CYCLE
-----------------------------------------------------
Name | APRIL L MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 724-357-7008
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------