Provider Demographics
NPI:1215316773
Name:WHS FAMILY MEDICINE-GREENE PLAZA
Entity type:Organization
Organization Name:WHS FAMILY MEDICINE-GREENE PLAZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCANLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-229-1756
Mailing Address - Street 1:220 GREENE PLZ
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-8144
Mailing Address - Country:US
Mailing Address - Phone:724-627-8582
Mailing Address - Fax:
Practice Address - Street 1:220 GREENE PLZ
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8144
Practice Address - Country:US
Practice Address - Phone:724-627-8582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA875375Medicare PIN