Organization
MOUNT NITTANY MEDICAL CENTER
Active
Parent organization
MOUNT NITTANY MEDICAL CENTER
Other names
Center for Wound Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNT NITTANY MEDICAL CENTER
Authorized official
BRYAN ROACH (CFO)
(814) 234-6148
Entity
Organization
Contact information
Practice address
120 RADNOR RD, STATE COLLEGE, PA 16801-7970
(814) 231-7868
(814) 238-4169
Mailing address
120 RADNOR RD, STATE COLLEGE, PA 16801-7970
(814) 231-7868
(814) 238-4169
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
550301
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007466550003
—
PA
01
—
390268
MEDICARE PROVIDER #
—
Enumeration date
04/29/2008
Last updated
04/10/2025
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