Organization
CONNEAUT VALLEY HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENATO J. SUNTAY (CHIEF FINANCIAL OFFICER)
(814) 373-2449
Entity
Organization
Contact information
Practice address
906 WASHINGTON ST, CONNEAUTVILLE, PA 16406
(814) 373-2276
(814) 587-2918
Mailing address
1009 WATER ST, SECOND FLOOR, MEADVILLE, PA 16335-3465
(814) 373-2449
(814) 373-3050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS011018L
PA
261QR1300X
Rural Health Clinic/Center
Primary
OS011018L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007230030001
—
PA
01
—
191386
HIGHMARK BC/BS
PA
01
—
CE7746
RAIL ROAD MEDICARE
PA
Enumeration date
07/19/2006
Last updated
04/16/2014
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