1780747980 NPI number — CHIRIGOS MEDICAL ASSOCIATES

Table of content: (NPI 1780747980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780747980 NPI number — CHIRIGOS MEDICAL ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIRIGOS MEDICAL ASSOCIATES
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:
1780747980
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
137 MATHEWS STREET
Provider Second Line Business Mailing Address:
STE 2000
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-837-9766
Provider Business Mailing Address Fax Number:
724-837-9769

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
137 MATHEWS STREET
Provider Second Line Business Practice Location Address:
STE 2000
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-9766
Provider Business Practice Location Address Fax Number:
724-837-9769
Provider Enumeration Date:
12/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHIRIGOS
Authorized Official First Name:
GREGG
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
724-837-9766

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  OS 006690L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MD 025155E , 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: 0883526 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2042467 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 388049 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: W288 . This is a "HEALTH AMERICA ADVANTRA H" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2042447 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1003553 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1249446 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 289C . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 606381 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 60838 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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