Provider Demographics
NPI:1669401568
Name:ALLEGHENY HEALTH INITIATIVES, LLP
Entity type:Organization
Organization Name:ALLEGHENY HEALTH INITIATIVES, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MCKIMM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-486-2202
Mailing Address - Street 1:416 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIUM
Mailing Address - State:PA
Mailing Address - Zip Code:15834-1402
Mailing Address - Country:US
Mailing Address - Phone:814-486-2202
Mailing Address - Fax:814-486-0998
Practice Address - Street 1:416 N BROAD ST
Practice Address - Street 2:
Practice Address - City:EMPORIUM
Practice Address - State:PA
Practice Address - Zip Code:15834-1402
Practice Address - Country:US
Practice Address - Phone:814-486-2202
Practice Address - Fax:814-486-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3303394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014145420001Medicaid
PA1739663OtherGROUP HIGHMARK NUMBER
PAV0918BOtherGROUP UPMC NUMBER
PADD8074OtherGROUP RAIL ROAD MEDICARE
PA1014145420001Medicaid