Healthcare Provider Details

I. General information

NPI: 1952539843
Provider Name (Legal Business Name): COMMUNITY ACTION MEDICAL SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 PARK STREET
CONFLUENCE PA
15424
US

IV. Provider business mailing address

418 PARK STREET
CONFLUENCE PA
15424
US

V. Phone/Fax

Practice location:
  • Phone: 724-439-1628
  • Fax:
Mailing address:
  • Phone: 724-439-1628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: ANN POKORNY-DESHONG
Title or Position: BOARD OF DIRECTORS, PRESIDENT
Credential:
Phone: 724-439-1628