Provider Demographics
NPI:1104119437
Name:FAMILY HEALTHCARE PARTNERS
Entity type:Organization
Organization Name:FAMILY HEALTHCARE PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-662-3943
Mailing Address - Street 1:400 W BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:PA
Mailing Address - Zip Code:16137-1090
Mailing Address - Country:US
Mailing Address - Phone:724-662-1930
Mailing Address - Fax:724-662-5054
Practice Address - Street 1:202 SPRUCE DR
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1412
Practice Address - Country:US
Practice Address - Phone:724-794-3358
Practice Address - Fax:724-794-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1530870Medicaid
778022Medicare PIN