| South End Primary Health Care, Pc | |
|
2100 Jane St Suite 110 Pittsburgh PA 15203-2075 | |
| (412) 586-1522 | |
| Not Available |
| Full Name | South End Primary Health Care, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2100 Jane St, Pittsburgh, Pennsylvania |
| Authorized Official Name and Position | Venkatlaxman B Reddy (OWNER) |
| Authorized Official Contact | 4129201111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South End Primary Health Care, Pc 2100 Jane St Ste 110 Pittsburgh PA 15203-2076 Ph: (412) 586-1522 | South End Primary Health Care, Pc 2100 Jane St Suite 110 Pittsburgh PA 15203-2075 Ph: (412) 586-1522 |
| NPI Number | 1598148579 |
|---|---|
| Provider Enumeration Date | 07/08/2015 |
| Last Update Date | 07/08/2015 |
| Medicare PECOS PAC ID | 3476869736 |
|---|---|
| Medicare Enrollment ID | O20150901001410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598148579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD056531L (Pennsylvania) | Primary |
| Provider Name | Deepika Pasunur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124018932 PECOS PAC ID: 8426951252 Enrollment ID: I20040129000667 |
| Provider Name | Venkatlaxman B Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811999790 PECOS PAC ID: 9133148695 Enrollment ID: I20051115000248 |
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