Healthcare Provider Details

I. General information

NPI: 1639775299
Provider Name (Legal Business Name): RENU PHYSICAL MEDICINE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 SWALLOW HILL RD STE 2600
PITTSBURGH PA
15220-1643
US

IV. Provider business mailing address

2275 SWALLOW HILL RD STE 2600
PITTSBURGH PA
15220-1643
US

V. Phone/Fax

Practice location:
  • Phone: 412-279-3398
  • Fax: 412-279-3828
Mailing address:
  • Phone: 412-279-3398
  • Fax: 412-279-3828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CINDY SCHUCHMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 412-279-3398