Healthcare Provider Details

I. General information

NPI: 1639138746
Provider Name (Legal Business Name): HEALTH SERVICES OF CLARION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 DOCTORS LN SUITE 201
CLARION PA
16214-8568
US

IV. Provider business mailing address

121 DOCTORS LANE
CLARION PA
16214-8515
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-6070
  • Fax: 814-226-4505
Mailing address:
  • Phone: 814-226-3470
  • Fax: 814-226-3479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1506264
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGATEWAY
# 2
Identifier1549213
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE SHIELD

VIII. Authorized Official

Name: CONNIE J BEICHNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 814-226-3470