Organization
CENTERVILLE CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY MARTOS (DIRECTOR FINANCE PERSONNEL)
(724) 632-6801
Entity
Organization
Contact information
Practice address
86 MCCLELLANDTOWN RD, UNIONTOWN, PA 15401-5527
(724) 430-7990
(724) 430-7993
Mailing address
1070 OLD NATIONAL PIKE RD, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440033
—
PA
Enumeration date
05/10/2007
Last updated
10/28/2009
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