Organization
CENTERVILLE CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA MARTOS (DIRECTOR OF FINANCE/PERSONNEL)
(724) 632-6801
Entity
Organization
Contact information
Practice address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
124Q00000X
Dental Hygienist
—
—
207KA0200X
Allergy Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026902
HGSA MEDICARE
PA
01
—
030163
HGSA MEDICARE
PA
01
—
031216
HGSA MEDICARE
PA
01
—
031218
HGSA MEDICARE
PA
01
—
031221
HGSA MEDICARE
PA
01
—
031395
HGSA MEDICARE
PA
01
—
032094
HGSA MEDICARE
PA
01
—
032095
HGSA MEDICARE
PA
05
—
1007288440027
—
PA
Enumeration date
11/11/2005
Last updated
01/23/2008
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