Healthcare Provider Details

I. General information

NPI: 1124088034
Provider Name (Legal Business Name): COMMUNITY FAMILY HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 05/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 CENTRE AVE
PITTSBURGH PA
15232
US

IV. Provider business mailing address

5215 CENTRE AVE
PITTSBURGH PA
15232
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2287
  • Fax: 412-623-6629
Mailing address:
  • Phone: 412-623-2287
  • Fax: 412-623-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK EHALT
Title or Position: SR. DIRECTOR
Credential:
Phone: 412-647-0943