Provider Demographics
NPI:1669773594
Name:WINDBER HOSPITAL INC
Entity type:Organization
Organization Name:WINDBER HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROSSE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:814-535-7576
Mailing Address - Street 1:321 MAIN ST
Mailing Address - Street 2:SUITE 3G
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1632
Mailing Address - Country:US
Mailing Address - Phone:814-535-7576
Mailing Address - Fax:814-536-1369
Practice Address - Street 1:600 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1331
Practice Address - Country:US
Practice Address - Phone:814-467-4750
Practice Address - Fax:814-467-4751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1760595755OtherTAESUN MOON, DO
1457336042OtherKIM R MARLEY MD
1568692549OtherNATHANIEL SANN CRNP
1568692549OtherNATHANIEL SANN CRNP
1053565804OtherDEBA SARMA MD