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Organization

INTEGRATED CARE CORP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICK PANICHELLE (FISCAL OPERATOR)
(724) 593-7447
Entity
Organization

Contact information

Practice address
371 BETHEL CHURCH RD, LIGONIER, PA 15658-2074
(724) 593-7447
(724) 593-7448
Mailing address
371 BETHEL CHURCH RD, LIGONIER, PA 15658-2074
(724) 593-7447
(724) 593-7448

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1000040110013
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000040110013
PA
Enumeration date
02/05/2007
Last updated
07/30/2010
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