Provider Demographics
NPI:1699737981
Name:FULTON COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:FULTON COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-485-3155
Mailing Address - Street 1:214 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-8559
Mailing Address - Country:US
Mailing Address - Phone:717-485-2880
Mailing Address - Fax:717-485-6105
Practice Address - Street 1:SOUTHERN HUNTINGDON COUNTY MEDICAL CENTER
Practice Address - Street 2:626 WATER STREET, STE#1
Practice Address - City:ORBISONIA
Practice Address - State:PA
Practice Address - Zip Code:17243
Practice Address - Country:US
Practice Address - Phone:814-447-5556
Practice Address - Fax:814-447-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008434780002Medicaid
PA0008434780002Medicaid