1194876847 NPI number — PREFERRED PRIMARY CARE PHYSICIANS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194876847 NPI number — PREFERRED PRIMARY CARE PHYSICIANS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREFERRED PRIMARY CARE PHYSICIANS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PPCP MCMURRAY BETHEL PARK BROOKLINE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194876847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 TECHNOLOGY DR STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANONSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-9531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-531-2902
Provider Business Mailing Address Fax Number:
412-531-2948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3928 WASHINGTON RD STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC MURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-2594
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-941-8877
Provider Business Practice Location Address Fax Number:
724-941-4745
Provider Enumeration Date:
01/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ERHARD
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
412-531-2902

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)