Provider Demographics
NPI:1457391385
Name:FRAZIER HART INC
Entity Type:Organization
Organization Name:FRAZIER HART INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERATH
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALING COORDI
Authorized Official - Phone:724-225-6500
Mailing Address - Street 1:125 NORTH FRANKLIN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-225-6500
Mailing Address - Fax:724-225-8188
Practice Address - Street 1:125 NORTH FRANKLIN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-225-6500
Practice Address - Fax:724-225-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA83661837207RC0000X
PA207RC000X207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009434820017Medicaid
PA0009434820001Medicaid
PA148559OtherBLUE SHIELD
PA148559Medicare PIN