Basic Information
| Provider Information | |||||||||
| NPI: | 1285067421 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEYERSDALE COMMUNITY HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NATHAN THOMAS PRACTICE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | MEYERSDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 155521249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146345911 | ||||||||
| FaxNumber: | 8146340435 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 INDUSTRIAL PARK RD | ||||||||
| Address2: | |||||||||
| City: | MEYERSDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 155527290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146345954 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2013 | ||||||||
| LastUpdateDate: | 02/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | LIBENGOOD | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8146345911 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.