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Organization

CONEMAUGH VALLEY MEMORIAL HOSPITAL

Active
Other names
Memorial Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWARD H DEFASQUALE (CHIEF FINANCIAL OFFICER)
(814) 534-5031
Entity
Organization

Contact information

Practice address
1086 FRANKLIN ST, CONEMAUGH EMERGENCY PHYSICIANS GROUP, JOHNSTOWN, PA 15905
(814) 534-9600
Mailing address
551 MAIN ST 3RD FLOOR ATTN NICOLLE, THE INFORMEDX GROUP, JOHNSTOWN, PA 15901
(814) 539-5724
(814) 536-7092

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007568490046
PA
Enumeration date
03/27/2006
Last updated
08/22/2020
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