Basic Information
| Provider Information | |||||||||
| NPI: | 1568577724 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARMSTRONG COUNTY MEMORIAL HOSPITAL | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ACMH HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 579 | ||||||||
| Address2: | |||||||||
| City: | KITTANNING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 162010579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245438524 | ||||||||
| FaxNumber: | 7245438616 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 NOLTE DR | ||||||||
| Address2: | |||||||||
| City: | KITTANNING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 162017111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245438524 | ||||||||
| FaxNumber: | 7245438616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2006 | ||||||||
| LastUpdateDate: | 02/11/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BURNS | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT OF FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 7245438168 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 270901 | PA | N | Ambulatory Health Care Facilities | Clinic/Center | 282N00000X | 270901 | PA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 000000060223 | 01 | PA | UNISON | OTHER | 0044 | 01 | BLUE CROSS | OTHER | 103575 | 01 | PA | UPMC | OTHER | 1007459070002 | 05 | PA | MEDICAID | 1009654 | 01 | PA | GATEWAY | OTHER | 390163 | 01 | PA | HEALTHAMERICA | OTHER | 0042137 | 01 | PA | UMWA | OTHER | 030031100 | 01 | PA | BLACK LUNG | OTHER |