Healthcare Provider Details

I. General information

NPI: 1912406240
Provider Name (Legal Business Name): PCMA PSYCHIATRIC DIVISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 OLIVER RD
SEWICKLEY PA
15143-1034
US

IV. Provider business mailing address

8526 SOUTH AVE
POLAND OH
44514-3620
US

V. Phone/Fax

Practice location:
  • Phone: 724-773-5215
  • Fax: 878-201-3584
Mailing address:
  • Phone: 866-289-8011
  • Fax: 330-758-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID THIMONS
Title or Position: OWNER
Credential: DO
Phone: 724-773-5215