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General NPI Number Information
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NPI Number | 1578872214
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Entity Type | Organization
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Legal Business Name | PRI-MED CARE INC
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 4479 RTE 136
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City | GREENSBURG
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State | PA
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Zip | 15601-6413
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Country | US
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Telephone | 724-836-4473
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Fax | 724-836-3835
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Provider Business Mailing Address
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Address Line | 4479 RTE 136
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City | GREENSBURG
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State | PA
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Zip | 15601-6413
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Country | US
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Telephone | 724-836-4473
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Fax | 724-836-3835
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WILLIAM JOHN MONSOUR
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Credential | M.D.
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Telephone | 724-836-4473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD-0524125-L
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License Number State | PA
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