Basic Information
| Provider Information | |||||||||
| NPI: | 1568884658 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHARON PENNSYLVANIA HOSPITAL COMPANY LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MERCER FAMILY MEDICINE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 699 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161462057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249833820 | ||||||||
| FaxNumber: | 7249833941 | ||||||||
| Practice Location | |||||||||
| Address1: | 551 GREENVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MERCER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161375019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246624155 | ||||||||
| FaxNumber: | 7246622352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2014 | ||||||||
| LastUpdateDate: | 10/06/2015 | ||||||||
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| AuthorizedOfficialLastName: | HOLTSFORD | ||||||||
| AuthorizedOfficialFirstName: | LAURIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 6154657466 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SHARON PENNSYLVANIA HOSPITAL COMPANY LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | 196601 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.