Basic Information
Provider Information
NPI: 1003131715
EntityType: 2
ReplacementNPI:  
OrganizationName: ARMSTRONG COUNTY MEMORIAL HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: HYPERBARIC WOUND ASSOCIATES
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 NOLTE DR
Address2: SNYDER INSTITUTE
City: KITTANNING
State: PA
PostalCode: 162017111
CountryCode: US
TelephoneNumber: 7245438500
FaxNumber:  
Practice Location
Address1: 1 NOLTE DR
Address2: SNYDER INSTITUTE
City: KITTANNING
State: PA
PostalCode: 162017111
CountryCode: US
TelephoneNumber: 7245438500
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2010
LastUpdateDate: 04/06/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BURNS
AuthorizedOfficialFirstName: PATRICK
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 7245438618
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ARMSTRONG COUNTY MEMORIAL HOSPITAL
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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