Basic Information
| Provider Information | |||||||||
| NPI: | 1144215039 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HIGHLANDS HOSPITAL AND HEALTH CENTER | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 401 E MURPHY AVE | ||||||||
| Address2: | |||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154252724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246281500 | ||||||||
| FaxNumber: | 7246262217 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 E MURPHY AVE | ||||||||
| Address2: | |||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154252724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246281500 | ||||||||
| FaxNumber: | 7246262217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2005 | ||||||||
| LastUpdateDate: | 02/07/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ANDURSKY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7246261500 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 282N00000X | 037301 | PA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 037331900 | 01 | BLACK LUNG | OTHER | 1007769210009 | 05 | PA | MEDICAID | 50 | 01 | UPMC | OTHER | 000000060233 | 01 | THREE RIVERS HEALTH PLAN | OTHER | 1069 | 01 | PA | BLUE CROSS SWING BED | OTHER | 1007769210016 | 05 | PA | MEDICAID | 401023 | 01 | MEDICARE GROUP | OTHER | 000000056000 | 01 | THREE RIVERS HEALTH PLAN | OTHER | 0013140 | 01 | USHC | OTHER | 1304 | 01 | PA | BLUE CROSS STEP DOWN | OTHER | 1005837 | 01 | GATEWAY | OTHER | 1503092 | 01 | UPMC FOR YOU | OTHER | 0036 | 01 | PA | BLUE CROSS ACUTE | OTHER | 1007769210010 | 05 | PA | MEDICAID | 1334532 | 01 | UMWA | OTHER |