Healthcare Provider Details

I. General information

NPI: 1750421301
Provider Name (Legal Business Name): MED HEALTH SERVICES MANAGEMENT, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JAMES PL
MONROEVILLE PA
15146-3445
US

IV. Provider business mailing address

200 JAMES PL
MONROEVILLE PA
15146-3445
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 TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier251408887
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerTRICARE
# 2
Identifier251408887
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerMOLINA HEALTHCARE
# 3
Identifier000000630218
Identifier TypeOTHER
Identifier State
Identifier IssuerANTHEM BLUE CROSS BLUE SHIELD
# 4
Identifier0014304450016
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPA MEDICAID FOR SKILLED NURSING FACILITIES
# 5
Identifier1361782
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUNITED HEALTHCARE
# 6
Identifier1361782
Identifier TypeOTHER
Identifier State
Identifier IssuerUMWA
# 7
Identifier2868624
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer
# 8
Identifier284488
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerADVANTRA
# 9
Identifier284488
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH AMERICA
# 10
IdentifierCB9198
Identifier TypeOTHER
Identifier State
Identifier IssuerRAILROAD MEDICARE WITH PALMETTO GBA
# 11
Identifier0014304450017
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 12
Identifier002125462
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerKEYSTONE HEALTH PLAN WEST
# 13
Identifier210657400
Identifier TypeOTHER
Identifier State
Identifier IssuerFEDERAL BLACK LUNG
# 14
Identifier000000243375
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerUNISON
# 15
Identifier251408887
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerDEVON
# 16
Identifier3810015726
Identifier TypeMEDICAID
Identifier StateWV
Identifier Issuer
# 17
Identifier0527961
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCIGNA

VIII. Authorized Official

Name: DR. OLIVER W CAMINOS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 412-372-2035