Organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Active
Parent organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Other names
HVMG Primary Care - Kennedy
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERITAGE VALLEY MEDICAL GROUP, INC.
Authorized official
MR. BRYAN J RANDALL (VICE PRESIDENT & CFO)
(412) 749-7027
Entity
Organization
Contact information
Practice address
27 HECKEL RD STE 210, MC KEES ROCKS, PA 15136-1673
(412) 262-4694
(412) 262-5920
Mailing address
1000 DUTCH RIDGE RD, BEAVER, PA 15009-9727
(724) 773-4776
(724) 773-4726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001565446
—
PA
Enumeration date
06/05/2019
Last updated
06/05/2019
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