Provider Demographics
NPI:1366431520
Name:BROOKVILLE HOSPITAL
Entity type:Organization
Organization Name:BROOKVILLE HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEFER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-849-3739
Mailing Address - Street 1:240 ALLEGHENY BLVD
Mailing Address - Street 2:SUITE M
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-2323
Mailing Address - Country:US
Mailing Address - Phone:814-849-3739
Mailing Address - Fax:814-849-1944
Practice Address - Street 1:240 ALLEGHENY BLVD
Practice Address - Street 2:SUITE M
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-2323
Practice Address - Country:US
Practice Address - Phone:814-849-3739
Practice Address - Fax:814-849-1944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007733760019Medicaid
PA397173Medicare ID - Type UnspecifiedPROVIDER NUMBER