Provider Demographics
NPI:1407191083
Name:OHIO VALLEY MEDICAL SERVICES
Entity Type:Organization
Organization Name:OHIO VALLEY MEDICAL SERVICES
Other - Org Name:OHIO VALLEY MEDICAL SERVICES - SPECIALTY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:412-777-6296
Mailing Address - Street 1:25 HECKEL RD
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1651
Mailing Address - Country:US
Mailing Address - Phone:412-777-6296
Mailing Address - Fax:412-777-6532
Practice Address - Street 1:25 HECKEL RD
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1651
Practice Address - Country:US
Practice Address - Phone:412-777-6296
Practice Address - Fax:412-777-6532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty