MEDICARE: MEDAID, 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
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	OC006255L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538374665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDAID, INC.

Provider Business Mailing Address
First Line	:	573 S MARKET ST
Second Line	:
City	:	NEW WILMINGTON
State	:	PA
Zip	:	16142-1307
Country	:	US
Telephone Number	:	724-946-9631
Fax Number	:

Provider Business Practice Location Address
First Line	:	527 E LONG AVE
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-4843
Country	:	US
Telephone Number	:	724-654-4545
Fax Number	:

Authorized Official
Title or Position	:	CLINIC MANAGER
Name	:	MR. MARK NAVYAC
Credential	:	P.T.
Telephone Number	:	724-654-4545

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	08/22/2020

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