Provider Demographics
NPI:1942540588
Name:PAIN SOLUTIONS OF ERIE LLC
Entity Type:Organization
Organization Name:PAIN SOLUTIONS OF ERIE LLC
Other - Org Name:RODNEY BINGHAM MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-647-2333
Mailing Address - Street 1:2409 STATE ST
Mailing Address - Street 2:SUITE 1R
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-1856
Mailing Address - Country:US
Mailing Address - Phone:814-454-6313
Mailing Address - Fax:814-454-6334
Practice Address - Street 1:2409 STATE ST
Practice Address - Street 2:SUITE 1R
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1856
Practice Address - Country:US
Practice Address - Phone:814-454-6313
Practice Address - Fax:814-454-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034640E208VP0000X
MD034640E208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011729590015Medicaid
PA40719Medicare PIN