| |
90 E 2nd St Emporium PA 15834-1302 | |
(814) 486-1115 | |
(814) 486-0404 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 90 E 2nd St, Emporium, Pennsylvania |
Authorized Official Name and Position | Ronald G Hammersley (CEO/ADMINISTRATOR) |
Authorized Official Contact | 8144861115 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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90 E 2nd St P.o. Box 270 Emporium PA 15834-1302 Ph: (814) 486-1115 | 90 E 2nd St Emporium PA 15834-1302 Ph: (814) 486-1115 |
NPI Number | 1699867325 |
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Provider Enumeration Date | 09/29/2006 |
Last Update Date | 09/24/2010 |
Identifier | Type | State | Issuer |
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1699867325 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Elk Regional Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 N Broad St, Emporium, PA 15834 Phone: 814-486-2202 Fax: 814-486-0973 | |
Keystone Rural Health Consortia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 90 E 2nd St, Emporium, PA 15834 Phone: 814-486-1115 Fax: 814-486-0404 | |