CENTERVILLE CLINICS, INC. – NPI #1790808962
Clinic/Center

CENTERVILLE CLINICS, INC. is an AHC clinic located in CONNELLSVILLE, PA. NPPES has assigned the NPI number 1790808962 to CENTERVILLE CLINICS, INC. on April 10, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 6 years ago on Dec 02, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTERVILLE CLINICS, INC. below.

NPI Profile for
CENTERVILLE CLINICS, INC.

NPI Number
1790808962
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTERVILLE CLINICS, INC.
Primary location
601 SOUTH ARCH STREET
CONNELLSVILLE, PA 15425
Phone: (724) 626-2630 Fax: (724) 626-2655
Mailing address
1070 OLD NATIONAL PIKE
FREDERICKTOWN, PA 15333-2114
Phone: (724) 632-6801 Fax: (724) 632-6312
Organization Subpart
No
Authorized Official
BARRY NICCOLAI
EXECUTIVE DIRECTOR
Phone: (724) 632-6801
Updated
Certification Date
Dec 02, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for CENTERVILLE CLINICS, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERNATIONAL GOVERNMENT SERVICESPA391911
MEDICAIDPA1007288440037
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
PA

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.