Provider Demographics
NPI:1679612022
Name:MONROEVILLE CHRISTIAN JUDEA FOUNDATION
Entity Type:Organization
Organization Name:MONROEVILLE CHRISTIAN JUDEA FOUNDATION
Other - Org Name:THE CEDARS OF MONROEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-373-3900
Mailing Address - Street 1:4363 NORTHERN PIKE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2807
Mailing Address - Country:US
Mailing Address - Phone:412-373-3900
Mailing Address - Fax:412-373-5600
Practice Address - Street 1:4363 NORTHERN PIKE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2807
Practice Address - Country:US
Practice Address - Phone:412-373-3900
Practice Address - Fax:412-373-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5007230001Medicare NSC