| Srhs Outpt D & A - Cop & Iop | |
|
2375 Garden Way Hermitage PA 16148-5209 | |
| (724) 983-5454 | |
| (724) 983-5428 |
| Full Name | Srhs Outpt D & A - Cop & Iop |
|---|---|
| Speciality | Clinic/center |
| Location | 2375 Garden Way, Hermitage, Pennsylvania |
| Authorized Official Name and Position | Jeff A Chrobak (VICE PRESIDENT, FINANCE) |
| Authorized Official Contact | 7249833815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Srhs Outpt D & A - Cop & Iop 699 E State St Sharon PA 16146-2057 Ph: (724) 983-3817 | Srhs Outpt D & A - Cop & Iop 2375 Garden Way Hermitage PA 16148-5209 Ph: (724) 983-5454 |
| NPI Number | 1235150954 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 11/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235150954 | NPI | - | NPPES |
| 1000000590014 | Medicaid | PA | |
| 1000000590104 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 437016 (Pennsylvania) | Secondary |
| 261Q00000X | Clinic/center | 437016 (* (Not Available)) | Primary |
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