Provider Demographics
NPI:1114376274
Name:GLADE RUN MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:GLADE RUN MEDICAL ASSOCIATES
Other - Org Name:ARMSTRONG EAR, NOSE, AND THROAT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE / CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-543-8618
Mailing Address - Street 1:700 MEDICAL ARTS BLDG
Mailing Address - Street 2:SUITE 710
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7141
Mailing Address - Country:US
Mailing Address - Phone:724-543-8626
Mailing Address - Fax:724-543-8736
Practice Address - Street 1:600 MEDICAL ARTS BLDG
Practice Address - Street 2:SUITE 620
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7134
Practice Address - Country:US
Practice Address - Phone:724-543-5991
Practice Address - Fax:724-543-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty