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General NPI Number Information
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NPI Number | 1043281660
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Entity Type | Organization
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Legal Business Name | MONROEVILLE SPECIALTY CLINIC INC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 125 DAUGHERTY DR
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City | MONROEVILLE
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State | PA
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Zip | 15146-2749
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Country | US
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Telephone | 412-374-9385
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Fax | 412-374-9490
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Provider Business Mailing Address
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Address Line | 125 DAUGHERTY DR
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City | MONROEVILLE
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State | PA
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Zip | 15146-2749
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Country | US
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Telephone | 412-374-9385
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Fax | 412-374-9490
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Authorized Official
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Title or Position | CFO
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Name | MRS. EILEEN SIMMONS
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Credential |
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Telephone | 412-647-7713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 04291500
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License Number State | PA
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