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Organization
PRIME MEDICAL GROUP
Active
Organization
PRIME MEDICAL GROUP
Active
Parent organization
PRIME MEDICAL GROUP
Other names
Prime Medical Long
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME MEDICAL GROUP
Authorized official
DARLA SETHMAN (ADMINISTRATOR)
(724) 929-2640
Entity
Organization
Contact information
Practice address
1645 ROSTRAVER RD, BELLE VERNON, PA 15012-9655
(724) 929-2260
Mailing address
PO BOX 18619, PITTSBURGH, PA 15236-0619
(724) 929-2640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000031306
HIGHMARK PROV NUMBER
PA
05
—
0006836970001
—
PA
05
—
0008635790002
—
PA
05
—
0010652420006
—
PA
05
—
0014690470004
—
PA
05
—
0019214160001
—
PA
05
—
1007726550009
—
PA
01
—
1936740
HIGHMARK
PA
01
—
31238
HIGHMARK
PA
01
—
692541
HIGHMARK
PA
01
—
692646
HIGHMARK
PA
01
—
717558
HIGHMARK
PA
01
—
769210
HIGHMARK
PA
Enumeration date
06/12/2006
Last updated
03/11/2009
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