Organization
CENTERVILLE CLINICS , INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA MARTOS (DIRECTOR 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
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207RG0100X
Gastroenterology Physician
OS003143L
PA
207RP1001X
Pulmonary Disease Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039196
HIGHMARK
PA
05
—
1007288440027
—
PA
Enumeration date
07/18/2006
Last updated
06/11/2010
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