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General NPI Number Information
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NPI Number | 1285533158
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Entity Type | Organization
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Legal Business Name | CENTERVILLE CLINICS , INC.
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 2160 SPRINGHILL FURNACE RD
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City | SMITHFIELD
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State | PA
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Zip | 15478-1428
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Country | US
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Telephone | 724-564-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 OLD NATIONAL PIKE
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City | FREDERICKTOWN
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State | PA
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Zip | 15333-2114
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Country | US
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Telephone | 724-632-6801
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Fax | 724-632-6312
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Authorized Official
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Title or Position | CEO
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Name | BARRY R NICCOLAI
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Credential |
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Telephone | 724-632-6801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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