MEDICARE: CONEMAUGH HEALTH INITIATIVES

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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CB9772	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457354623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONEMAUGH HEALTH INITIATIVES

Provider Business Mailing Address
First Line	:	1086 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-4305
Country	:	US
Telephone Number	:	814-410-8300
Fax Number	:	814-410-8331

Provider Business Practice Location Address
First Line	:	1086 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-4305
Country	:	US
Telephone Number	:	814-410-8300
Fax Number	:	814-410-8331

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELAINE M LAMBERT
Credential	:
Telephone Number	:	814-534-1630

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/08/2012

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Directions to “CONEMAUGH HEALTH INITIATIVES ” Practice Location

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