Organization
EAST LIBERTY FAMILY HEALTH CARE CENTER
Active
Organization
EAST LIBERTY FAMILY HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNE MEDLEY-LONG (EXECUTIVE DIRECTOR)
(412) 361-8284
Entity
Organization
Contact information
Practice address
7171 CHURCHLAND ST, PITTSBURGH, PA 15206-1217
(412) 345-0414
Mailing address
7171 CHURCHLAND ST, PITTSBURGH, PA 15206-1217
(412) 345-0414
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
MD024454E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007524920002
—
PA
01
—
3979955
NCDP
PA
Enumeration date
03/15/2007
Last updated
10/21/2009
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