Provider Demographics
NPI:1184772436
Name:BASH CHIROPRACTIC,INC
Entity type:Organization
Organization Name:BASH CHIROPRACTIC,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:BASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-465-2225
Mailing Address - Street 1:1022 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1676
Mailing Address - Country:US
Mailing Address - Phone:724-465-2225
Mailing Address - Fax:724-465-2225
Practice Address - Street 1:1022 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1676
Practice Address - Country:US
Practice Address - Phone:724-465-2225
Practice Address - Fax:724-465-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003723L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011520520002Medicaid
PAU01422Medicare UPIN
PA0011520520002Medicaid