Provider Demographics
NPI:1235458480
Name:EXCELA HEALTH PHYSICIAN PRACTICES, INC.
Entity Type:Organization
Organization Name:EXCELA HEALTH PHYSICIAN PRACTICES, INC.
Other - Org Name:EXCELA HEALTH WESTMORELAND PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & EXEC DIR, EHPP
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DISHONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-830-8500
Mailing Address - Street 1:134 INDUSTRIAL PARK RD
Mailing Address - Street 2:SUITE 2300A
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7328
Mailing Address - Country:US
Mailing Address - Phone:724-689-1810
Mailing Address - Fax:724-850-8096
Practice Address - Street 1:44 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2768
Practice Address - Country:US
Practice Address - Phone:724-689-1404
Practice Address - Fax:724-689-1405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCELA HEALTH HOLDING COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-27
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty