Organization
KEYSTONE RURAL HEALTH CONSORTIA, INC.
Active
Parent organization
KEYSTONE RURAL HEALTH CONSORTIA, INC
Other names
Kane Dental and Primary Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEYSTONE RURAL HEALTH CONSORTIA, INC
Authorized official
KRISTIE BENNARDI RN (CEO)
(814) 486-1115
Entity
Organization
Contact information
Practice address
90 E 2ND ST, EMPORIUM, PA 15834-1302
(814) 486-1115
Mailing address
PO BOX 270, EMPORIUM, PA 15834-0270
(814) 486-1115
(814) 486-1204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/03/2017
Last updated
05/13/2024
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