Provider Demographics
NPI:1699235374
Name:AHN EMERUS WESTMORELAND LLC
Entity type:Organization
Organization Name:AHN EMERUS WESTMORELAND LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. MED STAFF AND PROVIDER ENROLLME
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-637-1146
Mailing Address - Street 1:8686 NEW TRAILS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1176
Mailing Address - Country:US
Mailing Address - Phone:713-637-1146
Mailing Address - Fax:281-465-8414
Practice Address - Street 1:6321 ROUTE 30
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9703
Practice Address - Country:US
Practice Address - Phone:878-295-4735
Practice Address - Fax:724-523-3615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA390333OtherMEDICARE
PA103788819-001Medicaid