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
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
1501927
PA
2471M2300X
Mammography Radiologic Technologist
105916
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157508
HIGHMARK BLUE SHIELD
PA
Enumeration date
09/08/2006
Last updated
06/17/2010
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