Provider Demographics
NPI:1881869071
Name:ROBERT E SAUL
Entity type:Organization
Organization Name:ROBERT E SAUL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-748-7072
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:AVIS
Mailing Address - State:PA
Mailing Address - Zip Code:17721-0508
Mailing Address - Country:US
Mailing Address - Phone:570-748-7072
Mailing Address - Fax:570-748-7084
Practice Address - Street 1:930 BELLEFONTE AVE
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2754
Practice Address - Country:US
Practice Address - Phone:570-748-7072
Practice Address - Fax:570-748-7084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty
No246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2109347OtherAETNA
PA07021094Medicaid
PA220984OtherHEALTHAMERICA/COVENTRY