Healthcare Provider Details

I. General information

NPI: 1982666863
Provider Name (Legal Business Name): PERRYO MEDICAL CENTER, P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 LIBERTY STREET
PERRYOPOLIS PA
15473-0646
US

IV. Provider business mailing address

PO BOX 646
PERRYOPOLIS PA
15473-0646
US

V. Phone/Fax

Practice location:
  • Phone: 724-736-0443
  • Fax: 724-736-0454
Mailing address:
  • Phone: 724-736-0443
  • Fax: 724-736-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD049150L
License Number StatePA

VIII. Authorized Official

Name: DR. SANATKUMAR C SHROFF
Title or Position: PRESIDENT -OWNER
Credential: M.D.
Phone: 724-736-0443