| Conemaugh Physician Group - Portage | |
|
3670 Portage St Ste 105 Portage PA 15946-6546 | |
| (814) 736-9614 | |
| (814) 736-9783 |
| Full Name | Conemaugh Physician Group - Portage |
|---|---|
| Speciality | Clinic/Center |
| Location | 3670 Portage St, Portage, Pennsylvania |
| Authorized Official Name and Position | Jess N Judy (PRESIDENT) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conemaugh Physician Group - Portage 3670 Portage St Ste 105 Portage PA 15946-6546 Ph: (814) 736-9614 | Conemaugh Physician Group - Portage 3670 Portage St Ste 105 Portage PA 15946-6546 Ph: (814) 736-9614 |
| NPI Number | 1427464874 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 07/07/2014 |
| Medicare PECOS PAC ID | 7315166949 |
|---|---|
| Medicare Enrollment ID | O20140923000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427464874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Pioneer Medical Pa Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 132 Block Rd, Portage, PA 15946 Phone: 901-603-6113 | |
Conemaugh Health Initiatives Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3670 Portage St, Portage, PA 15946 Phone: 814-736-9614 Fax: 814-736-9783 |