Provider Demographics
NPI:1821541640
Name:IRMC/BHS MULTISPECIALTY PHYSICIAN GROUP INC
Entity type:Organization
Organization Name:IRMC/BHS MULTISPECIALTY PHYSICIAN GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLICKENDERFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-357-7333
Mailing Address - Street 1:640 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-357-7333
Mailing Address - Fax:724-357-7279
Practice Address - Street 1:119 PROFESSIONAL CTR
Practice Address - Street 2:1265 WAYNE AVENUE, SUITE 206
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3586
Practice Address - Country:US
Practice Address - Phone:724-284-5670
Practice Address - Fax:724-284-4144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IRMS/BHS MULTISPECIALTY PHYSICIAN GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-28
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicare Oscar/Certification