Provider Demographics
NPI:1033443114
Name:OLIVER W CAMINOS
Entity Type:Organization
Organization Name:OLIVER W CAMINOS
Other - Org Name:MED HEALTH SERVICES LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-373-7900
Mailing Address - Street 1:2490 MOSSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4236
Mailing Address - Country:US
Mailing Address - Phone:412-373-7900
Mailing Address - Fax:412-372-1645
Practice Address - Street 1:2490 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-373-7900
Practice Address - Fax:412-372-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA39D176771291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810013048OtherUNISYS
PA0014304450011Medicaid
OH2042873Medicaid
PA307379OtherBLUE SHIELD
PA1361782OtherUNITED HEALTHCARE
OH2042873Medicaid
PA307379Medicare PIN