Provider Demographics
NPI:1710319322
Name:PATRIOT SPINE, LTD
Entity Type:Organization
Organization Name:PATRIOT SPINE, LTD
Other - Org Name:PATRIOT-SPINE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:H.
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-427-4733
Mailing Address - Street 1:300 CAMP HORNE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-1627
Mailing Address - Country:US
Mailing Address - Phone:412-427-4733
Mailing Address - Fax:412-774-2774
Practice Address - Street 1:300 CAMP HORNE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-1627
Practice Address - Country:US
Practice Address - Phone:412-427-4733
Practice Address - Fax:412-774-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7153550001Medicare NSC