Organization
CENTERVILLE CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA MARTOS (DIRECTOR OF FIINANCE/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
(725) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026902
HGSA - MEDICARE
PA
05
—
1007288440027
—
PA
Enumeration date
11/10/2005
Last updated
04/18/2008
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