Provider Demographics
NPI:1649334780
Name:BERKEBILE CHIROPRACTIC
Entity type:Organization
Organization Name:BERKEBILE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERKEBILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-266-3775
Mailing Address - Street 1:801 SCALP AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-2554
Mailing Address - Country:US
Mailing Address - Phone:814-266-3775
Mailing Address - Fax:
Practice Address - Street 1:801 SCALP AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-2554
Practice Address - Country:US
Practice Address - Phone:814-266-3775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007550-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA218636OtherUPMC PENNSYLVANIA
PAP00124068OtherPALMETTO GBA
PABE915317OtherBLUE CROSS BLUE SHIELD PA
PABE044996Medicaid