Organization Name: | KEYSTONE RURAL HEALTH CONSORTIA, INC. |
NPI Number: | 1609968114 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTIE BENNARDI (ADMINISTRATOR) |
Mailing Address: | 90 E 2nd St Emporium |
State: | PA US |
Postal Code: | 158341302 |
Phone Number: | 8144861115 |
Fax Number: | 8144860404 |
NPI Enumeration Date: | 09/29/2006 |
NPI Last Update Date: | 05/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |