Provider Demographics
NPI:1922248848
Name:EDGEWOOD PROFESSIONAL SERVICES LLC
Entity type:Organization
Organization Name:EDGEWOOD PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:KURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-646-0400
Mailing Address - Street 1:239 EDGEWOOD DRIVE EXT
Mailing Address - Street 2:
Mailing Address - City:TRANSFER
Mailing Address - State:PA
Mailing Address - Zip Code:16154-1817
Mailing Address - Country:US
Mailing Address - Phone:800-223-5544
Mailing Address - Fax:724-294-3206
Practice Address - Street 1:225 EDGEWOOD DRIVE EXT
Practice Address - Street 2:
Practice Address - City:TRANSFER
Practice Address - State:PA
Practice Address - Zip Code:16154-1817
Practice Address - Country:US
Practice Address - Phone:724-646-7246
Practice Address - Fax:724-646-0413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty