Provider Demographics
NPI:1831641364
Name:HEGEMONY MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:HEGEMONY MANAGEMENT SERVICES, LLC
Other - Org Name:MILESTONES FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MITAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZOMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-863-9700
Mailing Address - Street 1:640 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PITCAIRN
Mailing Address - State:PA
Mailing Address - Zip Code:15140-1111
Mailing Address - Country:US
Mailing Address - Phone:724-863-9700
Mailing Address - Fax:724-909-1716
Practice Address - Street 1:8962 HILL DR
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-3112
Practice Address - Country:US
Practice Address - Phone:724-863-9700
Practice Address - Fax:724-909-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037134L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD037134LOtherPA LICENCE