Healthcare Provider Details

I. General information

NPI: 1497082507
Provider Name (Legal Business Name): FRG VETERANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2009
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 LIBERTY AVE STE 2000 THREE GATEWAY CENTER, 20TH FLOOR
PITTSBURGH PA
15222-1029
US

IV. Provider business mailing address

401 LIBERTY AVE STE 2000 THREE GATEWAY CENTER, 20TH FLOOR
PITTSBURGH PA
15222-1029
US

V. Phone/Fax

Practice location:
  • Phone: 412-223-2272
  • Fax: 412-281-6320
Mailing address:
  • Phone: 412-223-2272
  • Fax: 412-281-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERALD L JOHNSON
Title or Position: VICE PRESIDENT
Credential: PH.D.
Phone: 412-325-3403