Jha Markleysburg Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

060602 Issued in PA

Legal business name

JHA MARKLEYSBURG INC

Practice address

5253 National Pike
Markleysburg, PA 15459-1025

Phone

(724) 329-5545

Fax

(724) 329-1068

NPI assigned

Aug 31, 2005

Organization subpart

No

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

Authorized official

Name

Douglas K Mittleider

Title

President

Phone

(770) 619-0866

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Henry Clay Villa Doing business as

Locations

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1982697397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5253 NATIONAL PIKE",
            "city": "MARKLEYSBURG",
            "state": "PA",
            "postal_code": "154591025",
            "telephone_number": "724-329-5545",
            "fax_number": "724-329-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 NATIONAL PIKE",
            "city": "MARKLEYSBURG",
            "state": "PA",
            "postal_code": "154591025",
            "telephone_number": "724-329-5545",
            "fax_number": "724-329-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JHA MARKLEYSBURG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "MITTLEIDER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-619-0866"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "PA",
            "license": "060602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1696395",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Clay Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrie Clemons, OTR/L
• Henry Clay Villa LP
• Marclay EMS Inc
• Marclay EMS Inc.
• Markleysburg Comm Ambulance
• Kayla Miller
• Stephanie Miller

• All providers in Markleysburg, PA
• Nursing Facility/Intermediate Care Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.