Healthcare Provider Details

I. General information

NPI: 1467601443
Provider Name (Legal Business Name): EXCELA HEALTH QUICKCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8775 NORWIN AVE
NORTH HUNTINGDON PA
15642-2718
US

IV. Provider business mailing address

501 W OTTERMAN ST SUITE B
GREENSBURG PA
15601-2126
US

V. Phone/Fax

Practice location:
  • Phone: 724-850-6944
  • Fax: 724-836-6825
Mailing address:
  • Phone: 724-850-6933
  • Fax: 724-836-6825

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 Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER CLARKSON
Title or Position: DIRECTOR
Credential: MD
Phone: 724-850-6944