Keystone Rural Health Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Chambersburg, PA

NPI 1124026703 · NPPES record last updated Jun 17, 2026

Key facts

NPI
1124026703
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
KEYSTONE RURAL HEALTH CENTER
Practice address
767 5TH Ave Ste B-3a
Chambersburg, PA 17201-4207
Phone
(717) 709-7940
Fax
(717) 263-8014
NPI assigned
Jul 8, 2005
Organization subpart
Yes
Parent organization (as reported)
KEYSTONE RURAL HEALTH CENTER

Authorized official

Name
Joanne Cochran
Title
Ceo
Phone
(717) 709-7906

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Federally qualified health center certification: CCN 391921

Legal name
KEYSTONE RURAL HEALTH CENTER
Doing business as
KEYSTONE DENTAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 21, 2003
Last certification
Apr 21, 2003
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Sep 24, 1992 in PA
Enrollment address
767 5TH Ave B-3a
Chambersburg, PA 17201-4207

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Smith
Individual
Corporate Officer May 1, 2024
Muhammad Amer Chaudhry
Individual
Corporate Officer Jan 1, 2024
Carrie Gray
Individual
Corporate Officer
Chair
Oct 1, 2017
Michael Kugler
Individual
Corporate Officer
Board Member
Jan 1, 2014
Jenna Kaczmarek
Individual
Corporate Officer Jan 1, 2024
Timothy Henry
Individual
Corporate Director Dec 1, 2017
Scott Brown
Individual
Corporate Director Jun 2, 2021
Joanne L Cochran
Individual
Corporate Director
Ceo
Mar 18, 2014
W-2 Managing Employee
Ceo
May 12, 2010
William a Morgan
Individual
Corporate Officer
Board Member
Jan 1, 2014
Karen Pickenheim Johnston
Individual
Corporate Officer
Secretary
Jan 1, 2014
Wanda Dietrich
Individual
Corporate Officer Jul 4, 2024
Virginia Harriger
Individual
Corporate Director Nov 3, 2021
Sila Alegret-Bartel
Individual
Corporate Officer
Board Member
Jan 1, 2014
Brittany Henderson
Individual
Corporate Director
Board Member
Jan 5, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100506000210 PA Part a Provider - Federally Qualified Health Center (FQHC) 5496663312 Practice locations: Chambersburg, PA

National Provider Directory

Tax ID family
Keystone HLTH Ctr (42 organizations share this tax ID)
Part of
Keystone HLTH Ctr

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

767 5TH Ave Ste B-3a
Chambersburg, PA 17201-4207

Mailing address

111 Chambers Hill Dr Ste 200
Chambersburg, PA 17201-7304
Phone (717) 709-7922

Other names

  • Keystone Dental Care Fifth Avenue Doing business as
  • Keystone Dental Care Other name

Other providers in Chambersburg, PA

All providers in Chambersburg, PA · Federally Qualified Health Center (FQHC) in Pennsylvania

Sources for this page

Verify at the official NPI Registry.