| Millcreek Community Hospital | |
|
5401 Peach St Ste 3600 Erie PA 16509-2601 | |
| (814) 868-2170 | |
| (814) 866-8630 |
| Full Name | Millcreek Community Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 5401 Peach St Ste 3600, Erie, Pennsylvania |
| Authorized Official Name and Position | Michael Heller (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8148687758 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millcreek Community Hospital 5515 Peach St Erie PA 16509-2603 Ph: (814) 864-4031 | Millcreek Community Hospital 5401 Peach St Ste 3600 Erie PA 16509-2601 Ph: (814) 868-2170 |
| NPI Number | 1871128447 |
|---|---|
| Provider Enumeration Date | 03/04/2020 |
| Last Update Date | 03/04/2020 |
| Medicare PECOS PAC ID | 8426020173 |
|---|---|
| Medicare Enrollment ID | O20200616001909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871128447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| 208800000X | Urology | (* (Not Available)) | Secondary |
| Provider Name | Carmine D Damico |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801852884 PECOS PAC ID: 3577458876 Enrollment ID: I20040217000090 |
| Provider Name | Lori M Dulabon |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043477334 PECOS PAC ID: 4284800467 Enrollment ID: I20120110000800 |
| Provider Name | Jay Kiessling |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1386731248 PECOS PAC ID: 1355243791 Enrollment ID: I20120130000265 |
| Provider Name | Jason E Lee |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144459728 PECOS PAC ID: 1456515949 Enrollment ID: I20120613000439 |
| Provider Name | Michael Wayne Hankins |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1548782907 PECOS PAC ID: 5991061699 Enrollment ID: I20200728000390 |
| Provider Name | Colette Elizabeth Yori Tobia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1598147290 PECOS PAC ID: 3375807845 Enrollment ID: I20240229001678 |
| Provider Name | Neeru Agarwal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811962202 PECOS PAC ID: 6800844382 Enrollment ID: I20240401000017 |
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