| Port Allegany Area Family Practice Pc | |
|
1 Willow St Port Allegany PA 16743-1332 | |
| (814) 642-9531 | |
| (814) 642-2020 |
| Full Name | Port Allegany Area Family Practice Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Willow St, Port Allegany, Pennsylvania |
| Authorized Official Name and Position | Mark H Shelley (PRESIDENT) |
| Authorized Official Contact | 8146429531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Allegany Area Family Practice Pc 1 Willow St Port Allegany PA 16743-1332 Ph: (814) 642-9531 | Port Allegany Area Family Practice Pc 1 Willow St Port Allegany PA 16743-1332 Ph: (814) 642-9531 |
| NPI Number | 1962469486 |
|---|---|
| Provider Enumeration Date | 04/27/2006 |
| Last Update Date | 06/22/2022 |
| Medicare PECOS PAC ID | 4789669144 |
|---|---|
| Medicare Enrollment ID | O20040621000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962469486 | NPI | - | NPPES |
| CF9006 | Other | RAILROAD MEDICARE | |
| 0014032880001 | Medicaid | PA | |
| 861827 | Other | PA | HIGHMARK BLUE SHIELD |
| Provider Name | Mark Shelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336106954 PECOS PAC ID: 3173594991 Enrollment ID: I20101022001186 |
| Provider Name | Heather Deimler Kio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821724139 PECOS PAC ID: 0648655605 Enrollment ID: I20220913000384 |
Charles Cole Memorial Hosptial Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 N Pine St, Port Allegany, PA 16743 Phone: 814-642-7205 | |
Charles Cole Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 N Pine St, Port Allegany, PA 16743 Phone: 814-642-9655 | |
Charles Cole Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 45 N Pine St, Port Allegany, PA 16743 Phone: 814-642-9655 | |
Olean Medical Group Partnership Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 N Main St, Port Allegany, PA 16743 Phone: 814-642-0117 Fax: 814-642-0121 |