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General NPI Number Information
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NPI Number | 1669401568
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Entity Type | Organization
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Legal Business Name | ALLEGHENY HEALTH INITIATIVES, LLP
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 416 N BROAD ST
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City | EMPORIUM
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State | PA
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Zip | 15834-1402
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Country | US
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Telephone | 814-486-2202
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Fax | 814-486-0998
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Provider Business Mailing Address
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Address Line | 416 N BROAD ST
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City | EMPORIUM
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State | PA
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Zip | 15834-1402
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Country | US
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Telephone | 814-486-2202
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Fax | 814-486-0998
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Authorized Official
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Title or Position | PHYSCIAN PARTNER
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Name | DR. SCOTT RICHARD MCKIMM
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Credential | D.O.
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Telephone | 814-486-2202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3303394
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License Number State | PA
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