MEDICARE: ELK REGIONAL 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	314000000X	Skilled Nursing Facility	010902	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	0662	OTHER	PA	HIGHMARK SKILLED-NURSING
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770588709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELK REGIONAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	763 JOHNSONBURG RD
Second Line	:
City	:	SAINT MARYS
State	:	PA
Zip	:	15857-3417
Country	:	US
Telephone Number	:	814-788-8488
Fax Number	:	814-788-8085

Provider Business Practice Location Address
First Line	:	763 JOHNSONBURG RD
Second Line	:
City	:	SAINT MARYS
State	:	PA
Zip	:	15857-3417
Country	:	US
Telephone Number	:	814-788-8488
Fax Number	:	814-788-8085

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MRS. LAURIE MACDONALD
Credential	:
Telephone Number	:	814-788-5505

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/11/2019

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Directions to “ELK REGIONAL HEALTH CENTER ” Practice Location

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