Provider Demographics
NPI:1114430188
Name:ALLEGHENY CLINIC
Entity Type:Organization
Organization Name:ALLEGHENY CLINIC
Other - Org Name:AHN RODI ROAD PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTEMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-5864
Mailing Address - Street 1:324 RODI RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-3318
Mailing Address - Country:US
Mailing Address - Phone:412-731-7500
Mailing Address - Fax:412-731-4794
Practice Address - Street 1:324 RODI RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-3318
Practice Address - Country:US
Practice Address - Phone:412-731-7500
Practice Address - Fax:412-731-4794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty