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Organization

PEDIATRIC CARE SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHERRI LYNN PARSHALL (BILLING CLERK)
(814) 266-8840
Entity
Organization

Contact information

Practice address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 266-8840
(814) 266-8840
Mailing address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 266-8840
(814) 266-2176

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QP2300X
Primary Care Clinic/Center
MD-039547-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007708200003
PA
Enumeration date
09/21/2005
Last updated
05/20/2020
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