Healthcare Provider Details

I. General information

NPI: 1043662281
Provider Name (Legal Business Name): IRMC BHS MULTISPECIALTY PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 WAYNE AVENUE SUITE 206
INDIANA PA
15701-3578
US

IV. Provider business mailing address

640 KOLTER DR
INDIANA PA
15701-3570
US

V. Phone/Fax

Practice location:
  • Phone: 724-717-6417
  • Fax: 724-717-6418
Mailing address:
  • Phone: 724-357-7333
  • Fax: 724-357-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA J LUTTNER
Title or Position: CONTROLLER FINANCE AND ACCOUNTING
Credential: CFO
Phone: 724-357-7227