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296 Church St Petrolia PA 16050-0335 | |
(724) 756-2940 | |
(724) 756-8515 |
Full Name | |
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Speciality | Clinic/Center |
Location | 296 Church St, Petrolia, 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 | 296 Church St Petrolia PA 16050-0335 Ph: (724) 756-2940 |
NPI Number | 1538291828 |
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Provider Enumeration Date | 03/12/2007 |
Last Update Date | 07/11/2024 |
Medicare PECOS PAC ID | 9234046228 |
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Medicare Enrollment ID | O20080828000642 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538291828 | NPI | - | NPPES |
1007578460028 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |