Provider Demographics
NPI:1043571102
Name:XPERIENCE MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:XPERIENCE MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VERRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-444-4455
Mailing Address - Street 1:2121 NOBLESTOWN RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-3956
Mailing Address - Country:US
Mailing Address - Phone:412-444-4455
Mailing Address - Fax:
Practice Address - Street 1:2121 NOBLESTOWN RD
Practice Address - Street 2:SUITE 115
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-3956
Practice Address - Country:US
Practice Address - Phone:412-444-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026161L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1942293337OtherNPI