Provider Demographics
NPI:1851714950
Name:EDISON HEALTH P.C.
Entity Type:Organization
Organization Name:EDISON HEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-379-6160
Mailing Address - Street 1:1112 FELLS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-4713
Mailing Address - Country:US
Mailing Address - Phone:724-379-6160
Mailing Address - Fax:724-379-7203
Practice Address - Street 1:1112 FELLS CHURCH RD
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-4713
Practice Address - Country:US
Practice Address - Phone:724-379-6160
Practice Address - Fax:724-379-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420469208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty