Basic Information
Provider Information | |||||||||
NPI: | 1003833526 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | WESTMORELAND REGIONAL HOSPITAL | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 1100 | ||||||||
Address2: |   | ||||||||
City: | LATROBE | ||||||||
State: | PA | ||||||||
PostalCode: | 156505011 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7248324000 | ||||||||
FaxNumber: | 7248324468 | ||||||||
Practice Location | |||||||||
Address1: | 532 W PITTSBURGH ST | ||||||||
Address2: |   | ||||||||
City: | GREENSBURG | ||||||||
State: | PA | ||||||||
PostalCode: | 156012239 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7248324000 | ||||||||
FaxNumber: | 7248324468 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/17/2006 | ||||||||
LastUpdateDate: | 08/22/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | CURRY | ||||||||
AuthorizedOfficialFirstName: | JEFFREY | ||||||||
AuthorizedOfficialMiddleName: | T | ||||||||
AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESIDENT CEO | ||||||||
AuthorizedOfficialTelephone: | 7248324030 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X |   |   | Y |   | Hospital Units | Psychiatric Unit |   |
ID Information
ID | Type | State | Issuer | Description | 1007748470020 | 05 | PA |   | MEDICAID | 0933 | 01 |   | HIGHMARK BC BS | OTHER |