Provider Demographics
NPI:1366502346
Name:CENTIMED INC.
Entity Type:Organization
Organization Name:CENTIMED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-239-4030
Mailing Address - Street 1:511 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15314-1536
Mailing Address - Country:US
Mailing Address - Phone:724-239-4030
Mailing Address - Fax:724-239-2727
Practice Address - Street 1:511 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15314-1536
Practice Address - Country:US
Practice Address - Phone:724-239-4030
Practice Address - Fax:724-239-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018002050002Medicaid
PA1242650001Medicare ID - Type Unspecified