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NPI Code Detail

MEDICARE: CONEMAUGH HEALTH INITIATIVES

MEDICARE: CONEMAUGH HEALTH INITIATIVES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332900000XNon-Pharmacy Dispensing SiteOS011062LPA

General Provider Information

NPI Number : 1821130535
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONEMAUGH HEALTH INITIATIVES
Provider Business Mailing Address
First Line : 5626 OBERLIN DR
Second Line : SUITE 110
City : SAN DIEGO
State : CA
Zip : 92121-1705
Country : US
Telephone Number : 858-625-2990
Fax Number :
Provider Business Practice Location Address
First Line : 3670 PORTAGE ST
Second Line : SUITE 105
City : PORTAGE
State : PA
Zip : 15946-6546
Country : US
Telephone Number : 814-736-9614
Fax Number :
Authorized Official
Title or Position : VP OF OPERATIONS
Name : KENNY HEINE
Credential :
Telephone Number : 858-625-2990
Provider Enumeration Date : 02/12/2007
Last Update Date : 04/24/2013

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Directions to “CONEMAUGH HEALTH INITIATIVES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.