1548223654 NPI number — SPARTAN HEALTH SURGICENTER LLC

Table of content: DR. DANA CATHERINE MUELLER M.D. (NPI 1346549607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548223654 NPI number — SPARTAN HEALTH SURGICENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPARTAN HEALTH SURGICENTER 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:
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:
1548223654
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 STOOPS DRIVE
Provider Second Line Business Mailing Address:
GROUND FLOOR
Provider Business Mailing Address City Name:
MONONGAHELA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-483-2760
Provider Business Mailing Address Fax Number:
724-483-2762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 STOOPS DRIVE
Provider Second Line Business Practice Location Address:
GROUND FLOOR
Provider Business Practice Location Address City Name:
MONONGAHELA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-483-2760
Provider Business Practice Location Address Fax Number:
724-483-2762
Provider Enumeration Date:
04/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GARMAN
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
724-483-2760

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  1552 , 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: 1014402660001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com