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
835 HOSPITAL RD, INDIANA, PA 15701-3629
(724) 357-7008
(724) 357-7414
Mailing address
835 HOSPITAL RD, PO BOX 788, INDIANA, PA 15701-3629
(724) 357-7008
(724) 357-7414
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
090701
PA
282NR1301X
Rural Acute Care Hospital
Primary
090701
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000068
HIGHMARK
PA
01
—
1005099
GATEWAY
PA
05
—
100771353
—
PA
05
—
1007713530001
—
PA
Enumeration date
08/23/2005
Last updated
07/10/2024
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