Provider Demographics
NPI:1447443957
Name:HIGHLANDS HOSPITAL AND HEALTH CENTER
Entity type:Organization
Organization Name:HIGHLANDS HOSPITAL AND HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANDURSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-628-1500
Mailing Address - Street 1:401 E MURPHY AVE
Mailing Address - Street 2:P.O. BOX 1004
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425
Mailing Address - Country:US
Mailing Address - Phone:724-628-1500
Mailing Address - Fax:724-626-2334
Practice Address - Street 1:401 E MURPHY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425
Practice Address - Country:US
Practice Address - Phone:724-628-1500
Practice Address - Fax:724-626-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YP2500X
103T00000X, 207V00000X, 2084P0800X, 208600000X, 363LP0808X
PAOS013321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100776921Medicaid
PA1774039OtherHIGHMARK BC/BS GRP#
PACD5179OtherRAILROAD MEDICARE
PA091525Medicare UPIN