# HERITAGE VALLEY MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HERITAGE VALLEY MEDICAL GROUP, INC.
- **Other names:** HVMG Primary Care - Pine Hollow
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003477720
- **Legal business name:** HERITAGE VALLEY MEDICAL GROUP, INC.
- **Authorized official:** BRYAN J RANDALL (VICE PRESIDENT & CFO)
- **Authorized official phone:** (412) 749-7027

## Contact information

- **Practice address:** 596 PINE HOLLOW RD, MC KEES ROCKS, PA 15136-1661
- **Practice address phone:** (412) 771-6003
- **Practice address fax:** (412) 771-3575
- **Mailing address:** 596 PINE HOLLOW RD, MC KEES ROCKS, PA 15136-1661
- **Mailing address phone:** (412) 771-6003
- **Mailing address fax:** (412) 771-3575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2019
- **Last updated:** 06/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001565446 | — | PA |