MEDICARE: ELLWOOD MEDICAL CENTER OPERATIONS, LLC

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	282N00000X	General Acute Care Hospital	050501	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0076	OTHER	PA	HIGHMARK BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710087069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLWOOD MEDICAL CENTER OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	724 PERSHING ST
Second Line	:
City	:	ELLWOOD CITY
State	:	PA
Zip	:	16117-1474
Country	:	US
Telephone Number	:	724-752-0081
Fax Number	:	724-752-0966

Provider Business Practice Location Address
First Line	:	724 PERSHING ST
Second Line	:
City	:	ELLWOOD CITY
State	:	PA
Zip	:	16117-1474
Country	:	US
Telephone Number	:	724-752-0081
Fax Number	:	724-752-0966

Authorized Official
Title or Position	:	CEO
Name	:	BEVERLY ANNARUMO
Credential	:
Telephone Number	:	724-752-6750

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	11/25/2017

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