Provider Demographics
NPI:1326310467
Name:PANIN HEALTH CENTER INC
Entity Type:Organization
Organization Name:PANIN HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:PANIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-983-0442
Mailing Address - Street 1:589 N HERMITAGE RD
Mailing Address - Street 2:PO BOX 1545
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3227
Mailing Address - Country:US
Mailing Address - Phone:724-983-0442
Mailing Address - Fax:724-983-0410
Practice Address - Street 1:589 N HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3227
Practice Address - Country:US
Practice Address - Phone:724-983-0442
Practice Address - Fax:724-983-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002464L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008651070002Medicaid
PA0008651070002Medicaid