Provider Demographics
NPI:1427239375
Name:EXC., INC.
Entity type:Organization
Organization Name:EXC., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:F
Authorized Official - Last Name:KUZY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:724-239-2211
Mailing Address - Street 1:808 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15314-1214
Mailing Address - Country:US
Mailing Address - Phone:724-785-6578
Mailing Address - Fax:724-239-2233
Practice Address - Street 1:321 FRONT ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-1936
Practice Address - Country:US
Practice Address - Phone:724-785-6578
Practice Address - Fax:724-239-2233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXC., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA473100310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility