Provider Demographics
NPI:1386607125
Name:SHARON REGIONAL HEALTH SYSTEM
Entity type:Organization
Organization Name:SHARON REGIONAL HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FOR FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHROBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-983-3815
Mailing Address - Street 1:699 E STATE ST
Mailing Address - Street 2:SRHS BUSINESS OFFICE
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2057
Mailing Address - Country:US
Mailing Address - Phone:724-983-3820
Mailing Address - Fax:724-983-3941
Practice Address - Street 1:2320 HIGHLAND RD
Practice Address - Street 2:CANCER CARE CENTER
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2819
Practice Address - Country:US
Practice Address - Phone:724-983-3878
Practice Address - Fax:724-983-5949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHARON REGIONAL HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA153999251E00000X, 251G00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
300046OtherVALUE OPTIONS/HEALTH AMER
1013OtherPA BLUE CROSS
PA1000000590004Medicaid
13178OtherAETNA
000000156716OtherANTHEM
1013OtherPA BLUE CROSS
=========022OtherMEDICAL MUTUAL OF OHIO
=========022OtherMEDICAL MUTUAL OF OHIO