Organization
INDIANA REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL F ICKOWSKI CPA, MBA (CHIEF FINANCIAL OFFICER)
(724) 357-7008
Entity
Organization
Contact information
Practice address
INDIANA AT CHESTNUT RIDGE, 25 COLONY BLVD, BLAIRSVILLE, PA 15717
(724) 357-7009
(724) 357-7414
Mailing address
PO BOX 788, 835 HOSPITAL ROAD, INDIANA, PA 15701-0788
(724) 357-7009
(724) 357-7414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
090701
PA
261QU0200X
Urgent Care Clinic/Center
090701
PA
Other
Enumeration date
07/14/2009
Last updated
07/10/2024
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