# MEMORIAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003010992
- **Authorized official:** MRS. LISA ANN HASLETT MSN, CRNP (NURSE PRACTITIONER)
- **Authorized official phone:** (814) 534-9503

## Contact information

- **Practice address:** 1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
- **Practice address phone:** (814) 534-9503
- **Mailing address:** 434 BLUE RIDGE DR, MOON TWP, PA 15108-5500
- **Mailing address phone:** (724) 457-1511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NC2000X | Children's Hospital | VP001816J | PA | Yes |

## Other

- **Enumeration date:** 06/13/2007
- **Last updated:** 03/19/2012