Provider Demographics
NPI:1942496179
Name:MEDICARE HEALTH INSURANCE
Entity Type:Organization
Organization Name:MEDICARE HEALTH INSURANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:WILLIS
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:II
Authorized Official - Credentials:HENERY FOLB
Authorized Official - Phone:724-942-6480
Mailing Address - Street 1:20 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15323-1272
Mailing Address - Country:US
Mailing Address - Phone:724-663-4251
Mailing Address - Fax:
Practice Address - Street 1:20 5TH ST
Practice Address - Street 2:
Practice Address - City:CLAYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15323-1272
Practice Address - Country:US
Practice Address - Phone:724-663-4251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA22926710282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access