Provider Demographics
NPI:1538320270
Name:ST CLAIR MEDICAL SERVICES
Entity Type:Organization
Organization Name:ST CLAIR MEDICAL SERVICES
Other - Org Name:ST CLAIR OCCUPATIONAL MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PAMALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATNESKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-942-2548
Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-924-2548
Mailing Address - Fax:
Practice Address - Street 1:2000 OXFORD DR STE 100
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1898
Practice Address - Country:US
Practice Address - Phone:412-942-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CLAIR HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-24
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
001612916OtherHIGHMARK