Provider Demographics
NPI:1104395862
Name:SCHOLASTIC HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SCHOLASTIC HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DONALD LEWIS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:412-328-6927
Mailing Address - Street 1:1160 FORSYTH PL
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-1411
Mailing Address - Country:US
Mailing Address - Phone:412-328-6927
Mailing Address - Fax:877-300-9025
Practice Address - Street 1:517 BROADWAY ST STE 500
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3167
Practice Address - Country:US
Practice Address - Phone:412-328-6927
Practice Address - Fax:877-300-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-24
Last Update Date:2018-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty