1265494165 NPI number — CPTS, LLC

Table of content: (NPI 1194077784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265494165 NPI number — CPTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CPTS, LLC
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:
Provider Other Organization Name Type Code:
6
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:
1265494165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
180 N GALLATIN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIONTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15401-2969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-437-0250
Provider Business Mailing Address Fax Number:
724-437-0403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 N GALLATIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-2969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-437-0250
Provider Business Practice Location Address Fax Number:
724-437-0403
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SWEENEY
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PHYSICAL THERAPIST/OWNER
Authorized Official Telephone Number:
724-437-0520

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT003137L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: SW1338930 . This is a "HIGHMARK PROVIDER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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