MEDICARE: WESTMORELAND PRIMARY HEALTH CENTER

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1497852347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTMORELAND PRIMARY HEALTH CENTER

Provider Business Mailing Address
First Line	:	210 W CHURCH ST
Second Line	:
City	:	LIGONIER
State	:	PA
Zip	:	15658-1106
Country	:	US
Telephone Number	:	724-238-2121
Fax Number	:	724-238-4755

Provider Business Practice Location Address
First Line	:	210 W CHURCH ST
Second Line	:
City	:	LIGONIER
State	:	PA
Zip	:	15658-1106
Country	:	US
Telephone Number	:	724-238-2121
Fax Number	:	724-238-4755

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JOHN SPHON
Credential	:
Telephone Number	:	724-850-8591

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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