Provider Demographics
NPI:1396777181
Name:CENTER MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:CENTER MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-375-3199
Mailing Address - Street 1:99 AUTUMN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1301
Mailing Address - Country:US
Mailing Address - Phone:724-375-3199
Mailing Address - Fax:724-375-5858
Practice Address - Street 1:99 AUTUMN ST
Practice Address - Street 2:SUITE100
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1301
Practice Address - Country:US
Practice Address - Phone:724-375-3199
Practice Address - Fax:724-375-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008863OtherGATEWAY HEALTH PLAN
PA1008867OtherGATEWAY HEALTH PLAN
OH0708578Medicaid
PA1007297430012Medicaid
0549284OtherAETNA
PAV02654OtherUPMC
PA1007297430013Medicaid
PA511197OtherBLUE SHIELD
0549283OtherAETNA
PA1008863OtherGATEWAY HEALTH PLAN
PA1007297430013Medicaid