=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790570067
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELK REGIONAL HEALTH CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2025
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 763 JOHNSONBURG RD STE 100
-----------------------------------------------------
City | SAINT MARYS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15857-3400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-788-8000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 763 JOHNSONBURG RD
-----------------------------------------------------
City | SAINT MARYS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15857-3400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-375-4200
-----------------------------------------------------
Fax | 814-375-4232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | JOURDAN STRISHOCK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 814-375-6160
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------