Basic Information
| Provider Information | |||||||||
| NPI: | 1174685283 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELK REGIONAL HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 763 JOHNSONBURG ROAD | ||||||||
| Address2: | |||||||||
| City: | ST. MARYS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15857 | ||||||||
| CountryCode: | US | ||||||||
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| FaxNumber: | 8147888234 | ||||||||
| Practice Location | |||||||||
| Address1: | 763 JOHNSONBURG RD | ||||||||
| Address2: | |||||||||
| City: | SAINT MARYS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 158573417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8147888232 | ||||||||
| FaxNumber: | 8147888234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 07/25/2016 | ||||||||
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| AuthorizedOfficialLastName: | SEKELSKY | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | FINANCIAL ANALYST | ||||||||
| AuthorizedOfficialTelephone: | 8147888232 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1007292600027 | 05 | PA | MEDICAID |