Provider Demographics
NPI:1609209022
Name:CONNECTED HEALTH MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:CONNECTED HEALTH MEDICAL SERVICES LLC
Other - Org Name:CONNECTED HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-933-4320
Mailing Address - Street 1:12620 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8662
Mailing Address - Country:US
Mailing Address - Phone:412-913-1840
Mailing Address - Fax:412-799-0107
Practice Address - Street 1:12620 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8662
Practice Address - Country:US
Practice Address - Phone:412-913-1840
Practice Address - Fax:724-933-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047727L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty