Centerville Clinics Inc | |
Centerville Clinics-donora Family Medicine 718 Mckean Avenue Donora PA 15033-1061 | |
(724) 379-4401 | |
Not Available |
Full Name | Centerville Clinics Inc |
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Speciality | Clinic/Center |
Location | Centerville Clinics-donora Family Medicine, Donora, Pennsylvania |
Authorized Official Name and Position | Barry R Niccolai (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7246326801 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Centerville Clinics Inc Centerville Clinics Inc 1070 Old National Pike Road Fredericktown PA 15333-2114 Ph: (724) 632-6801 | Centerville Clinics Inc Centerville Clinics-donora Family Medicine 718 Mckean Avenue Donora PA 15033-1061 Ph: (724) 379-4401 |
NPI Number | 1164064002 |
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Provider Enumeration Date | 10/11/2019 |
Last Update Date | 10/11/2019 |
Medicare PECOS PAC ID | 7214837202 |
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Medicare Enrollment ID | O20210217003122 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164064002 | NPI | - | NPPES |
1007288440027 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |