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Organization

FEDERAL BUREAU OF PRISONS

Active
Other names
Federal Correctional Institution, Loretto
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY G. TRIMBATH PA-C/MPAS (HEALTH SERVICES ADMINISTRATOR/PA-C)
(814) 471-1579
Entity
Organization

Contact information

Practice address
772 SAINT JOSEPH ST, LORETTO, PA 15940-7006
(814) 471-1579
(814) 471-1596
Mailing address
772 SAINT JOSEPH ST, LORETTO, PA 15940-7006
(814) 471-1579
(814) 471-1596

Taxonomy

Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary

Other

Enumeration date
05/02/2012
Last updated
05/02/2012
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