Healthcare Provider Details

I. General information

NPI: 1265754998
Provider Name (Legal Business Name): AMC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 02/28/2018
Certification Date:
Deactivation Date: 11/20/2015
Reactivation Date: 02/28/2018

III. Provider practice location address

2626 SIGSBEE STREET
ERIE PA
16508-1808
US

IV. Provider business mailing address

PO BOX 9471
ERIE PA
16505
US

V. Phone/Fax

Practice location:
  • Phone: 814-746-2747
  • Fax: 814-879-0969
Mailing address:
  • Phone: 814-746-2747
  • Fax: 814-879-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANN MARIE CARBO
Title or Position: R.N.
Credential:
Phone: 814-746-1447