Organization
SPECIAL SERVICES CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE LEE SIMMONS (EXECUTIVE DIRECTOR)
(724) 728-6284
Entity
Organization
Contact information
Practice address
1000 DUTCH RIDGE RD, THE MEDICAL CENTER, BEAVER, PA 15009-9727
(724) 728-7000
Mailing address
300 S WALNUT LN, SUITE 100, BEAVER, PA 15009-1739
(724) 728-6539
(724) 728-7416
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010761010005
—
PA
Enumeration date
12/27/2005
Last updated
02/20/2008
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