Healthcare Provider Details

I. General information

NPI: 1437483369
Provider Name (Legal Business Name): MED HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 MOSSIDE BLVD
MONROEVILLE PA
15146
US

IV. Provider business mailing address

2490 MOSSIDE BLVD
MONROEVILLE PA
15146
US

V. Phone/Fax

Practice location:
  • Phone: 412-373-7900
  • Fax: 412-372-1645
Mailing address:
  • Phone: 412-373-7900
  • Fax: 412-372-1645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD035918L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number39D0176771
License Number StatePA

VIII. Authorized Official

Name: MRS. JOSEPHINE C ORIA
Title or Position: CFO
Credential:
Phone: 412-373-7900