Healthcare Provider Details

I. General information

NPI: 1154450179
Provider Name (Legal Business Name): JRMC PHYS SERV CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3703
US

IV. Provider business mailing address

PO BOX 18119 MOB #310
PITTSBURGH PA
15236-0119
US

V. Phone/Fax

Practice location:
  • Phone: 412-469-7932
  • Fax: 412-469-5493
Mailing address:
  • Phone: 412-469-7932
  • Fax: 412-469-5493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: ROBERT A FRANK
Title or Position: EXEC. VP & COO, CORP ADMINISTRATION
Credential:
Phone: 412-469-5487