Provider Demographics
NPI:1376508077
Name:HUGHES PHYSICAL THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:HUGHES PHYSICAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-593-8880
Mailing Address - Street 1:420 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:ACME
Mailing Address - State:PA
Mailing Address - Zip Code:15610-1218
Mailing Address - Country:US
Mailing Address - Phone:724-547-3657
Mailing Address - Fax:724-547-5586
Practice Address - Street 1:3802 STATE ROUTE 31
Practice Address - Street 2:SUITE 2
Practice Address - City:DONEGAL
Practice Address - State:PA
Practice Address - Zip Code:15628-4033
Practice Address - Country:US
Practice Address - Phone:724-593-8880
Practice Address - Fax:724-593-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015390225100000X
PAOC001781L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7385679OtherAETNA
PA1013719190001Medicaid
PA1600108OtherCIGNA
PA259237OtherHEALTH AMERICA/HEALTH ASS
PA259237OtherHEALTH AMERICA/HEALTH ASS
PA090444Medicare ID - Type Unspecified