Provider Demographics
NPI:1841416732
Name:JOHNSTOWN INTERNISTS, INC.
Entity Type:Organization
Organization Name:JOHNSTOWN INTERNISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:POTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-536-8949
Mailing Address - Street 1:353 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1711
Mailing Address - Country:US
Mailing Address - Phone:814-536-8949
Mailing Address - Fax:814-539-6065
Practice Address - Street 1:353 MARKET ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1711
Practice Address - Country:US
Practice Address - Phone:814-536-8949
Practice Address - Fax:814-539-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011500110006Medicaid