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416 N Broad St Emporium PA 15834-1402 | |
(814) 486-2202 | |
(814) 486-0973 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 416 N Broad St, Emporium, Pennsylvania |
Authorized Official Name and Position | Brian S Kline (VP, CFO & AUTHORIZED OFFICIAL) |
Authorized Official Contact | 8143756377 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Hospital Ave Du Bois PA 15801-1440 Ph: (814) 375-4200 | 416 N Broad St Emporium PA 15834-1402 Ph: (814) 486-2202 |
NPI Number | 1649427071 |
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Provider Enumeration Date | 08/27/2008 |
Last Update Date | 10/30/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649427071 | NPI | - | NPPES |
100774088 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (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 | |