MEDICARE: TITUSVILLE AREA HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1053873976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TITUSVILLE AREA HOSPITAL

Provider Business Mailing Address
First Line	:	1034 GROVE ST
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2945
Country	:	US
Telephone Number	:	814-382-0446
Fax Number	:	814-382-7386

Provider Business Practice Location Address
First Line	:	10926 STATE HIGHWAY 18
Second Line	:
City	:	CONNEAUT LAKE
State	:	PA
Zip	:	16316-3526
Country	:	US
Telephone Number	:	814-382-0446
Fax Number	:	814-382-7386

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	JILL ANN NEELY
Credential	:
Telephone Number	:	814-827-1851

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	04/01/2019

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Directions to “TITUSVILLE AREA HOSPITAL ” Practice Location

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