Organization · Type 2 NPI

Broad Top Area Medical Center, Inc

Federally Qualified Health Center (FQHC) · Mount Union, PA

NPI number 1174039408 Active

Practice location

95 S Park St
Mount Union, PA 17066-1334

Call (815) 542-8627 Map

Fax (814) 542-5444

Mailing address

4133 Medical Center Dr
Broad Top, PA 16621-9001

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

Dawn M. Mills, PACMedical Physician Assistant Mount Union, PA NPI 1083860472
Kevin Charles Capp, DOFamily Medicine Physician Mount Union, PA NPI 1588800155

NPI record

NPI: 1174039408
Entity type: Organization (Type 2)
Issued: Dec 22, 2017
Last updated: Aug 28, 2026
Status: Active
Subpart: Yes of Broad Top Area Medical Center Inc

Other names

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Btamc MT Union Medical Center · doing business as
Mount Union Area Medical Center · doing business as

Authorized official

Shani Reed
Director, Enrollment
(814) 506-8463

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174039408

Broad Top Area Medical Center, Inc's National Provider Identifier is 1174039408, issued on Dec 22, 2017. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Mount Union, PA. The record was last updated on Aug 28, 2026.