| Conneaut Valley Health Center Inc. | |
|
906 Washington St Conneautville PA 16406 | |
| (814) 373-2276 | |
| (814) 587-2918 |
| Full Name | Conneaut Valley Health Center Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 906 Washington St, Conneautville, Pennsylvania |
| Authorized Official Name and Position | Renato J. Suntay (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8143732449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conneaut Valley Health Center Inc. 1009 Water St Second Floor Meadville PA 16335-3465 Ph: (814) 373-2449 | Conneaut Valley Health Center Inc. 906 Washington St Conneautville PA 16406 Ph: (814) 373-2276 |
| NPI Number | 1558380469 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 04/16/2014 |
| Medicare PECOS PAC ID | 1456319706 |
|---|---|
| Medicare Enrollment ID | O20050103000751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558380469 | NPI | - | NPPES |
| 0007230030001 | Medicaid | PA | |
| CE7746 | Other | PA | RAIL ROAD MEDICARE |
| 191386 | Other | PA | HIGHMARK BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS011018L (Pennsylvania) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | OS011018L (Pennsylvania) | Primary |
| Provider Name | Joseph Mercurio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487620712 PECOS PAC ID: 1557378726 Enrollment ID: I20060313000489 |
| Provider Name | John B Nesbitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679505028 PECOS PAC ID: 0345278560 Enrollment ID: I20090202000214 |
| Provider Name | Jennifer Jocuns Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205958022 PECOS PAC ID: 3476711367 Enrollment ID: I20120223000378 |
| Provider Name | Peter J Mccarthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902124506 PECOS PAC ID: 4183867351 Enrollment ID: I20130909000252 |
| Provider Name | Jenna L Cassidy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710288253 PECOS PAC ID: 2860626553 Enrollment ID: I20131011001365 |
| Provider Name | Joseph M Wendekier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700165644 PECOS PAC ID: 2264665983 Enrollment ID: I20140505001641 |
| Provider Name | Lee Spain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427281559 PECOS PAC ID: 9537386164 Enrollment ID: I20140805002755 |
| Provider Name | Elizabeth A Ramsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710290010 PECOS PAC ID: 6103044276 Enrollment ID: I20140903000171 |
| Provider Name | Serena Mott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184977506 PECOS PAC ID: 6709000763 Enrollment ID: I20140925000638 |
| Provider Name | Sharon J Danforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700288859 PECOS PAC ID: 1658593587 Enrollment ID: I20141110001487 |
| Provider Name | Theresa M Carlucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174922058 PECOS PAC ID: 4284956483 Enrollment ID: I20141125000296 |
| Provider Name | Lori A Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528436045 PECOS PAC ID: 6608173075 Enrollment ID: I20160330000825 |
Conneaut Valley Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 906 Washington St, Conneautville, PA 16406 Phone: 814-587-2246 Fax: 814-587-4144 |