# OLEAN GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OLEAN GENERAL HOSPITAL
- **Other names:** The Pavilion at BRMC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124014691
- **Legal business name:** OLEAN GENERAL HOSPITAL
- **Authorized official:** JILL M. OWENS MD (CEO)
- **Authorized official phone:** (716) 373-2600

## Contact information

- **Practice address:** 200 PLEASANT STREET, BRADFORD, PA 16701
- **Practice address phone:** (814) 362-8599
- **Practice address fax:** (814) 363-5110
- **Mailing address:** 200 PLEASANT STREET, BRADFORD, PA 16701
- **Mailing address phone:** (814) 362-8293
- **Mailing address fax:** (814) 363-5110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 024702 | PA | Yes |

## Other

- **Enumeration date:** 09/21/2005
- **Last updated:** 10/10/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0517 | HIGH MARK BLUE CROSS | PA |
| 05 | — | 1007507650046 | — | PA |