| |
99 Autumn St Aliquippa PA 15001-1301 | |
(724) 857-3570 | |
(724) 857-3574 |
Full Name | |
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Speciality | Clinic/Center |
Location | 99 Autumn St, Aliquippa, Pennsylvania |
Authorized Official Name and Position | Carl A Sizer (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7243420126 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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63 Pitt St Sharon PA 16146-2102 Ph: (724) 342-3002 | 99 Autumn St Aliquippa PA 15001-1301 Ph: (724) 857-3570 |
NPI Number | 1992073183 |
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Provider Enumeration Date | 12/02/2011 |
Last Update Date | 05/01/2024 |
Medicare PECOS PAC ID | 9234046228 |
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Medicare Enrollment ID | O20120530000258 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992073183 | NPI | - | NPPES |
0261071 | Medicaid | OH | |
1007578460104 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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