Healthcare Provider Details

I. General information

NPI: 1760832182
Provider Name (Legal Business Name): PHRQL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PENN AVE STE 301
PITTSBURGH PA
15206-3926
US

IV. Provider business mailing address

6101 PENN AVE STE 301
PITTSBURGH PA
15206-3926
US

V. Phone/Fax

Practice location:
  • Phone: 412-996-8400
  • Fax:
Mailing address:
  • Phone: 412-996-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number
License Number State

VIII. Authorized Official

Name: PAUL T SANDBERG
Title or Position: PRESIDENT & CEO
Credential:
Phone: 412-996-8400