Healthcare Provider Details

I. General information

NPI: 1821084039
Provider Name (Legal Business Name): MON VALLEY COMMUNITY HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EASTGATE AVE STE 101
MONESSEN PA
15062-1392
US

IV. Provider business mailing address

2 EASTGATE AVE STE 101
MONESSEN PA
15062-1392
US

V. Phone/Fax

Practice location:
  • Phone: 724-684-8999
  • Fax: 724-684-7073
Mailing address:
  • Phone: 724-684-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLIE MCKEVITT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 724-489-9100