Provider Demographics
NPI:1760521611
Name:MED HEALTH SERVICES MANAGEMENT, LP
Entity Type:Organization
Organization Name:MED HEALTH SERVICES MANAGEMENT, LP
Other - Org Name:MED HEALTH SERVICES LAB
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KONDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-443-2035
Mailing Address - Street 1:200 JAMES PL
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3445
Mailing Address - Country:US
Mailing Address - Phone:412-373-7900
Mailing Address - Fax:412-372-1645
Practice Address - Street 1:200 JAMES PL
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3445
Practice Address - Country:US
Practice Address - Phone:412-373-7900
Practice Address - Fax:412-372-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA39D0176771291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2042873Medicaid
WV3810013048Medicaid
PA14304450011Medicaid
PA251408887OtherDEVON
PA284488OtherHEALTH AMERICA
WV3810013048Medicaid
PA690007618OtherINDEPENDANT LAB
PA307379OtherKEYSTONE HEALTH PLAN WEST
PA1361782OtherUMWA
PA14304450011Medicaid
PA307379Medicare PIN