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General NPI Number Information
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NPI Number | 1912906207
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Entity Type | Organization
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Legal Business Name | MOUNT NITTANY MEDICAL CENTER
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 1800 E PARK AVE
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City | STATE COLLEGE
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State | PA
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Zip | 16803-6701
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Country | US
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Telephone | 814-231-7024
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | NEW CUMBERLAND
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State | PA
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Zip | 17070-0726
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Country | US
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Telephone | 717-214-6018
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Fax | 717-214-6020
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Authorized Official
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Title or Position | ALS SUPERVISOR
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Name | RICH KELLEY
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Credential |
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Telephone | 814-231-7024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 02283
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License Number State | PA
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