NPIMap

Organization Active NPI

Warren General Hospital

  • Rural Health Clinic/Center
  • Warren, PA
National Provider Identifier
1750104774
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WARREN GENERAL HOSPITAL
Practice address
2265 Market St Ste B
Warren, PA 16365-4682
Phone
(814) 757-5860
NPI assigned
Nov 7, 2024
Organization subpart
Yes
Parent organization
WARREN GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie Snyder
Title
Executive Director of Finance
Phone
(814) 723-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2265 Market St Ste B
Warren, PA 16365-4682

Mailing address

2 W Crescent Park
Warren, PA 16365-2111
Phone (814) 723-3300

Other names 1

  • Warren General Hospital RHC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241118000585 PA Part A Provider - Rural Health Clinic 4880501402 Practice locations: Warren, PA

Rural health clinic certification: CCN 393457

Legal name
WARREN GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 23, 2025
Last certification
May 23, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
2265 Market St
Ste B
Warren, PA 16365-4682
Related CCNs
390146

Other NPIs with the same Medicare PAC ID 9

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0972810Warren General Hospital2265 Market St, Warren, PA 16365Certificate of waiverApr 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Warren General Hosp Lab17 organizations share this tax ID, including this one
Part of
Warren General Hosp Lab

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Laurie Macdonald Individual Corporate OfficerCfo May 15, 2023
W-2 Managing EmployeeCfo May 15, 2023
Julia McTavish Individual OtherChairman Sep 1, 2018
Vikas Sacher Individual W-2 Managing Employee Jan 1, 2025
Other Jan 1, 2025
Mason Tootell Individual OtherBoard Member Sep 1, 2018
Warren General Hospital Organization, Warren, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2018 55%
Gwendolynn Scutella Individual OtherBoard Member Jul 1, 2024
Ahn-Lecom JV LLC Organization, Pittsburgh, PA Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2018 45%
Timothy Scott Stanton Individual W-2 Managing Employee Sep 1, 2018
OtherBoard Member Sep 1, 2018
Kathryn Carlson Individual Corporate OfficerCoo Jul 1, 2025
W-2 Managing EmployeeCoo Jul 1, 2025
Brian Devine Individual OtherVice Chairman Dec 19, 2023
Thad Turner Individual OtherBoard Member Sep 1, 2018
Timothy Bevevino Individual OtherBoard Member Sep 1, 2018
Steven Inman Individual OtherBoard Member Dec 19, 2023
Karen Surkala Individual OtherBoard Member Apr 23, 2020
Trevor Olsen Individual W-2 Managing Employee Sep 1, 2018
OtherBoard Member Sep 1, 2018
Joseph J Maljovec Individual OtherBoard Member Jan 1, 2020
Robert a Kaemmerer Individual Other Sep 24, 2025
Jasen Diley Individual OtherBoard Member Oct 1, 2018
Randall Scalise Individual OtherBoard Member Mar 1, 2022
Julie Snyder Individual Corporate DirectorExecutive Director of Finance Mar 5, 2012
W-2 Managing EmployeeExecutive Director of Finance Mar 5, 2012
Daniel W Grolemund Individual Corporate OfficerCeo Jul 1, 2025
W-2 Managing EmployeeCeo Jul 1, 2025

Owners & managing parties with NPI records 13

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 13

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Warren General HospitalWarren, PA, CCN 393458 Rural health clinic 5% Or Greater Direct Ownership Interest (55%) Sep 1, 2018
Warren General Hospital RHC Sugar GroveSugar Grove, PA, CCN 393456 Rural health clinic 5% Or Greater Direct Ownership Interest (55%) Sep 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1750104774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 MARKET ST STE B",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163654682",
            "telephone_number": "814-757-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WARREN GENERAL HOSPITAL",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "814-723-3300"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warren General Hospital RHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.