Basic Information
| Provider Information | |||||||||
| NPI: | 1154450179 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JRMC PHYS SERV CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 18119 | ||||||||
| Address2: | MOB #310 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152360119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124697932 | ||||||||
| FaxNumber: | 4124695493 | ||||||||
| Practice Location | |||||||||
| Address1: | 565 COAL VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124697932 | ||||||||
| FaxNumber: | 4124695493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 09/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | FRANK | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | EXEC. VP & COO, CORP ADMINISTRATION | ||||||||
| AuthorizedOfficialTelephone: | 4124695487 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.