| Port Allegany Pediatrics | |
|
45 N Pine St Port Allegany PA 16743-1238 | |
| (814) 642-7205 | |
| Not Available |
| Full Name | Port Allegany Pediatrics |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 45 N Pine St, Port Allegany, Pennsylvania |
| Authorized Official Name and Position | Edward Pitchford (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8142745216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Allegany Pediatrics 45 N Pine St Port Allegany PA 16743-1238 Ph: (814) 642-7205 | Port Allegany Pediatrics 45 N Pine St Port Allegany PA 16743-1238 Ph: (814) 642-7205 |
| NPI Number | 1104990514 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104990514 | NPI | - | NPPES |
| 001376403 | Other | PA | BLUE SHIELD |
| 100001127-0072 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Port Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 N Pine St, Port Allegany, PA 16743 Phone: 814-642-9655 | |
Port Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 45 N Pine St, Port Allegany, PA 16743 Phone: 814-642-9655 | |
Olean Medical Group Partnership Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 N Main St, Port Allegany, PA 16743 Phone: 814-642-0117 Fax: 814-642-0121 | |
Upper Allegheny Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Willow St, Port Allegany, PA 16743 Phone: 814-642-9531 Fax: 814-642-2020 |