Provider Demographics
NPI:1255849683
Name:PUNXSUTAWNEY MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:PUNXSUTAWNEY MEDICAL SERVICES, INC
Other - Org Name:PUNXSUTAWNEY ANESTHESIA SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-938-1886
Mailing Address - Street 1:81 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2605
Mailing Address - Country:US
Mailing Address - Phone:814-938-1886
Mailing Address - Fax:814-938-1885
Practice Address - Street 1:81 HILLCREST DR
Practice Address - Street 2:PUNXSUTAWNEY ANESTHESIA SERVICE
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-938-1886
Practice Address - Fax:814-938-1885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PUNXSUTAWNEY MEDICAL SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty