Provider Demographics
NPI:1992017537
Name:THREE RIVERS TRAVEL MEDICINE
Entity Type:Organization
Organization Name:THREE RIVERS TRAVEL MEDICINE
Other - Org Name:TRAVELREADYMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-496-8966
Mailing Address - Street 1:116 ALYSON DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3664
Mailing Address - Country:US
Mailing Address - Phone:724-942-5498
Mailing Address - Fax:
Practice Address - Street 1:1370 WASHINGTON PIKE
Practice Address - Street 2:SUITE 107
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2862
Practice Address - Country:US
Practice Address - Phone:412-528-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 061194L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty