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Contact Information

LIGHTHOUSE MEDICAL, LLC
301 E. PLEASANT VALLEY BLVD
ALTOONA, PA16602
 Phone: 814-944-5835
 Fax: 814-944-9184
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for LIGHTHOUSE MEDICAL, LLC

NPI Number 1306184858
LBN Legal business name LIGHTHOUSE MEDICAL, LLC
Authorized official JOHN JOHNSON - (CEO/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/17/2013
Last updated 02/28/2017 - About 9 years ago
Identifiers
PA License # MD044867E
PA License # MD438515
PA Medicaid 1020712560001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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