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NPI Code Detail

MEDICARE: BRAVIS ENTERPRISES INC

MEDICARE: BRAVIS ENTERPRISES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

General Provider Information

NPI Number : 1144473620
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRAVIS ENTERPRISES INC
Provider Business Mailing Address
First Line : 200 RENAISSANCE DR.
Second Line : SUITE 301
City : BUTLER
State : PA
Zip : 16001-7612
Country : US
Telephone Number : 724-282-0755
Fax Number : 724-282-7723
Provider Business Practice Location Address
First Line : 200 RENAISSANCE DR.
Second Line : SUITE 301
City : BUTLER
State : PA
Zip : 16001-7612
Country : US
Telephone Number : 724-282-0755
Fax Number : 724-282-7723
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. KELLI A THOMPSON
Credential : BS, RRT
Telephone Number : 724-282-0755
Provider Enumeration Date : 10/29/2008
Last Update Date : 10/29/2008

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Directions to “BRAVIS ENTERPRISES INC ” Practice Location

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