Provider Demographics
NPI:1235258724
Name:COLON & RECTAL CARE CENTER OF PENNSYLVANIA LLC
Entity Type:Organization
Organization Name:COLON & RECTAL CARE CENTER OF PENNSYLVANIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-853-6580
Mailing Address - Street 1:1225 S MAIN ST
Mailing Address - Street 2:SUITE 302A
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5370
Mailing Address - Country:US
Mailing Address - Phone:724-853-6580
Mailing Address - Fax:724-853-6582
Practice Address - Street 1:1225 S MAIN ST
Practice Address - Street 2:SUITE 302A
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5370
Practice Address - Country:US
Practice Address - Phone:724-853-6580
Practice Address - Fax:724-853-6582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1857264OtherCIGNA
PA4240513OtherAETNA PPO
PA1291853OtherAETNA HMO
PA000919764002OtherUNITEDHEALTHCARE
PA1796670OtherHIGHMARK BLUES
PA441474OtherHEALTH AMERICA
PA1291853OtherAETNA HMO
PA1857264OtherCIGNA