Organization
CENTERVILLE CLINICS, INC.
Active
Organization
CENTERVILLE CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA MARTOS (DIRECTOR PERSONNEL/FINANCE)
(724) 632-6801
Entity
Organization
Contact information
Practice address
1150 7TH ST, WAYNESBURG, PA 15370-1660
(724) 627-8243
Mailing address
1070 OLD N ATIONAL PIKE ROAD, FREDERICKTOWN, PA 15333
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
391811
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440036
—
PA
Enumeration date
09/10/2007
Last updated
07/16/2010
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