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General NPI Number Information
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NPI Number | 1912290008
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Entity Type | Organization
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Legal Business Name | ICARE MEDICAL
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 100 SUSAN DR
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City | JOHNSTOWN
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State | PA
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Zip | 15905-2826
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Country | US
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Telephone | 814-509-0099
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5657
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City | JOHNSTOWN
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State | PA
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Zip | 15904-5657
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Country | US
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Telephone | 814-509-0099
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAFOUH MALHIS
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Credential | MD
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Telephone | 814-509-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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