Basic Information
Provider Information
NPI: 1730400912
EntityType: 2
ReplacementNPI:  
OrganizationName: CLEARFIELD AREA PHYSICIAN SERVICES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 809 TURNPIKE AVE
Address2:  
City: CLEARFIELD
State: PA
PostalCode: 168301232
CountryCode: US
TelephoneNumber: 8147682356
FaxNumber: 8147682134
Practice Location
Address1: 809 TURNPIKE AVE
Address2:  
City: CLEARFIELD
State: PA
PostalCode: 168301232
CountryCode: US
TelephoneNumber: 8147682356
FaxNumber: 8147682134
Other Information
ProviderEnumerationDate: 06/22/2010
LastUpdateDate: 06/22/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: OLSZEWSKI
AuthorizedOfficialFirstName: RITA
AuthorizedOfficialMiddleName: V
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 8147682356
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: CLEARFIELD AREA HEALTH SERVICES CORPORATION
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM1300X  Y Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty

No ID Information.


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