Provider Demographics
NPI:1811214232
Name:CHIROPRACTIC HEALTHCARE, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMARI-PAPOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-498-4401
Mailing Address - Street 1:214 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3223
Mailing Address - Country:US
Mailing Address - Phone:724-498-4401
Mailing Address - Fax:724-498-4770
Practice Address - Street 1:214 ENCLAVE DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3223
Practice Address - Country:US
Practice Address - Phone:724-498-4401
Practice Address - Fax:724-498-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-24
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005647-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA152885OtherMED PLUS/THREE RIVERS HEALTH
PA251614117OtherDEVON
PA8191631OtherCIGNA
PA42211/152885OtherUNISON
PA7160666OtherAETNA
PA1027804OtherAMERICAN SPECIALTY HEALTH
PA682212OtherACN GROUP
PA682212OtherUNITED HEALTHCARE
PA182799OtherMEDICARE PTAN
PA1306143OtherHIGHMARK
PA5719468OtherCOVENTRY/FIRST HEALTH
PA152885OtherMED PLUS/THREE RIVERS HEALTH
PAU82621Medicare UPIN