Provider Demographics
NPI:1720470156
Name:ALLEGHENY HEALTH MEDICAL LLC
Entity Type:Organization
Organization Name:ALLEGHENY HEALTH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-224-2224
Mailing Address - Street 1:825 FREEPORT RD.
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014
Mailing Address - Country:US
Mailing Address - Phone:724-224-2224
Mailing Address - Fax:724-226-3988
Practice Address - Street 1:825 10TH AVE
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014-1085
Practice Address - Country:US
Practice Address - Phone:724-224-2224
Practice Address - Fax:724-226-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S014539207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty