Healthcare Provider Details

I. General information

NPI: 1730534595
Provider Name (Legal Business Name): PUNXSUTAWNEY MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HILLCREST DR
PUNXSUTAWNEY PA
15767-2605
US

IV. Provider business mailing address

81 HILLCREST DR
PUNXSUTAWNEY PA
15767-2605
US

V. Phone/Fax

Practice location:
  • Phone: 814-938-3343
  • Fax: 814-938-3369
Mailing address:
  • Phone: 814-938-3343
  • Fax: 814-938-3369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JACK G SISK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 814-938-1882