Provider Demographics
NPI:1316762107
Name:MCELHINNY, TAMMIE (CPO, CFM)
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:MCELHINNY
Suffix:
Gender:F
Credentials:CPO, CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14074 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-7544
Mailing Address - Country:US
Mailing Address - Phone:814-547-4766
Mailing Address - Fax:
Practice Address - Street 1:900 WATER ST # 6.1
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3428
Practice Address - Country:US
Practice Address - Phone:814-547-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOH000038222Z00000X
PAPO000018224P00000X
PA2057224900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Multi-Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty