Provider Demographics
NPI:1639689797
Name:ST CLAIR MEDICAL SERVICES
Entity Type:Organization
Organization Name:ST CLAIR MEDICAL SERVICES
Other - Org Name:WEST HILLS MEDICAL
Other - Org Type:Former Legal Business Name
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:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:27 HECKEL RD STE 212
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1695
Practice Address - Country:US
Practice Address - Phone:412-777-4319
Practice Address - Fax:412-777-4390
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CLAIR HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-03
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001828752Medicaid