Provider Demographics
NPI:1306988001
Name:OHIO VALLEY MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:OHIO VALLEY MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TEFERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-777-6547
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-0049
Mailing Address - Country:US
Mailing Address - Phone:412-937-5700
Mailing Address - Fax:412-937-5739
Practice Address - Street 1:25 HECKEL RD
Practice Address - Street 2:
Practice Address - City:MCKEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136
Practice Address - Country:US
Practice Address - Phone:412-777-6478
Practice Address - Fax:412-777-6908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1920240OtherBLUE SHIELD
PA1018718180001Medicaid
PA111646Medicare PIN
PA1920240OtherBLUE SHIELD