Provider Demographics
NPI:1396723367
Name:BOROUGH OF MOUNT PLEASANT
Entity type:Organization
Organization Name:BOROUGH OF MOUNT PLEASANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:BRYCE
Authorized Official - Last Name:GERGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-309-6933
Mailing Address - Street 1:409 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1141
Mailing Address - Country:US
Mailing Address - Phone:724-887-6822
Mailing Address - Fax:724-887-9440
Practice Address - Street 1:100 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2015
Practice Address - Country:US
Practice Address - Phone:724-547-4620
Practice Address - Fax:724-542-7893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA031053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011455400002Medicaid
PA104440OtherUPMC HEALTH PLAN
PA211754OtherBLUE CROSS/BLUE SHIELD
PA1006518OtherGATEWAY HEALTH PLAN
PA590005003OtherRR MEDICARE/PALMETTO GBA
PA590005003OtherPALMETTO GBA
PA0011455400003Medicaid
PA334053OtherHEALTH AMERICA
PA=========OtherTRICARE
PA590005003OtherRR MEDICARE/PALMETTO GBA