Provider Demographics
NPI:1821705245
Name:EXCELA HEALTH PHYSICIAN PRACTICES, INC
Entity Type:Organization
Organization Name:EXCELA HEALTH PHYSICIAN PRACTICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:VARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-850-6933
Mailing Address - Street 1:601 MICHIGAN AVENUE
Mailing Address - Street 2:BOTTOM LEVEL
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2433
Mailing Address - Country:US
Mailing Address - Phone:724-689-0429
Mailing Address - Fax:724-522-5308
Practice Address - Street 1:601 MICHIGAN AVENUE
Practice Address - Street 2:BOTTOM LEVEL
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-1564
Practice Address - Country:US
Practice Address - Phone:724-689-0429
Practice Address - Fax:724-522-5308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCELA HEALTH HOLDING COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty