1750684692 NPI number — CRITCHFIELD SPECIALTY INFUSION GROUP, LLC

Table of content: DR. DAVID KENNETH AUSTIN MD (NPI 1275506503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750684692 NPI number — CRITCHFIELD SPECIALTY INFUSION GROUP, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRITCHFIELD SPECIALTY INFUSION GROUP, 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:
1750684692
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30
Provider Second Line Business Mailing Address:
742 SOUTH MAIN STREET
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-0030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-834-6600
Provider Business Mailing Address Fax Number:
724-834-2058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
742 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-4137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-6600
Provider Business Practice Location Address Fax Number:
724-834-2058
Provider Enumeration Date:
12/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CRITCHFIELD
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-834-0541

Provider Taxonomy Codes

  • Taxonomy code: 163WI0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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