Provider Demographics
NPI:1487075131
Name:HYNDMAN AREA HEALTH CENTER, INC.
Entity type:Organization
Organization Name:HYNDMAN AREA HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTYCZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-709-9801
Mailing Address - Street 1:144 5TH AVE
Mailing Address - Street 2:PO BOX 706
Mailing Address - City:HYNDMAN
Mailing Address - State:PA
Mailing Address - Zip Code:15545-7379
Mailing Address - Country:US
Mailing Address - Phone:814-842-3206
Mailing Address - Fax:814-842-3746
Practice Address - Street 1:144 5TH AVE
Practice Address - Street 2:
Practice Address - City:HYNDMAN
Practice Address - State:PA
Practice Address - Zip Code:15545-7379
Practice Address - Country:US
Practice Address - Phone:814-842-3206
Practice Address - Fax:814-842-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007332810003Medicaid