Provider Demographics
NPI:1992754014
Name:HYNDMAN AREA HEALTH CENTER, INC.
Entity type:Organization
Organization Name:HYNDMAN AREA HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-842-3206
Mailing Address - Street 1:144 FIFTH AVENUE
Mailing Address - Street 2:PO BOX 706
Mailing Address - City:HYNDMAN
Mailing Address - State:PA
Mailing Address - Zip Code:15545-0706
Mailing Address - Country:US
Mailing Address - Phone:814-842-3206
Mailing Address - Fax:814-842-9169
Practice Address - Street 1:144 FIFTH AVENUE
Practice Address - Street 2:
Practice Address - City:HYNDMAN
Practice Address - State:PA
Practice Address - Zip Code:15545-0706
Practice Address - Country:US
Practice Address - Phone:814-842-3206
Practice Address - Fax:814-842-9169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDUSD032440261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007332810011Medicaid
PA120657OtherHIGHMARK
WV3810008167Medicaid
PA1007332810003Medicaid
MD402063700Medicaid
PA391924Medicare Oscar/Certification
WV3810001525Medicaid
PA1007332810006Medicaid
WV3810001525Medicaid