Provider Demographics
NPI:1588408520
Name:J C BLAIR MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:J C BLAIR MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOURDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRISHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-375-6160
Mailing Address - Street 1:239 COLONNADE BLVD
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2668
Mailing Address - Country:US
Mailing Address - Phone:814-643-8408
Mailing Address - Fax:
Practice Address - Street 1:239 COLONNADE BLVD
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2668
Practice Address - Country:US
Practice Address - Phone:814-643-8408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy