Basic Information
| Provider Information | |||||||||
| NPI: | 1487665949 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARMSTRONG PATHOLOGY ASSO PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 28 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242283400 | ||||||||
| FaxNumber: | 7242287040 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 NOLTE DR | ||||||||
| Address2: | ARMSTRONG HOSPITAL | ||||||||
| City: | KITTANNING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245438122 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CHILDS | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7245438122 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 0010418770003 | 05 | PA | MEDICAID |