Organization
KEYSTONE RURAL HEALTH CONSORTIA INC
Active
Other names
Mountaintop Area Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD G HAMMERSLEY (CEO/ADMINISTRATOR)
(814) 486-1115
Entity
Organization
Contact information
Practice address
402 EAST SYCAMORE STREET, SNOW SHOE, PA 16874-0402
(814) 387-6857
(814) 387-6870
Mailing address
90 EAST SECOND STREET, EMPORIUM, PA 15834-1302
(814) 486-1115
(814) 486-0404
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007763960018
—
PA
Enumeration date
09/29/2006
Last updated
01/28/2011
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