Provider Demographics
NPI:1972597854
Name:WINDBER HOSPITAL, INC.
Entity type:Organization
Organization Name:WINDBER HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SUKENIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-467-3444
Mailing Address - Street 1:600 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-1331
Mailing Address - Country:US
Mailing Address - Phone:814-467-3000
Mailing Address - Fax:814-467-3407
Practice Address - Street 1:427 PARK PLACE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1331
Practice Address - Country:US
Practice Address - Phone:814-467-3727
Practice Address - Fax:814-467-8692
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDBER HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-07
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA744205251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0866OtherHIGHMARK BLUE CROSS
PA1007703740018Medicaid
PA1007703740018Medicaid