Provider Demographics
NPI:1962525576
Name:EXCELAHEALTH LATROBE HOSPITAL
Entity type:Organization
Organization Name:EXCELAHEALTH LATROBE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRATTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:724-537-1000
Mailing Address - Street 1:EXCELAHEALTH LATROBE AREA HOSPITAL
Mailing Address - Street 2:121 WEST SECOND AVE.
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2551
Mailing Address - Country:US
Mailing Address - Phone:724-537-1000
Mailing Address - Fax:724-537-1918
Practice Address - Street 1:EXCELAHEALTH LATROBE AREA HOSPITAL
Practice Address - Street 2:121 WEST SECOND AVE.
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2551
Practice Address - Country:US
Practice Address - Phone:724-537-1000
Practice Address - Fax:724-537-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW003900L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPO5479Medicare UPIN