Mainline Medical Associates, Inc.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

MD023791E Issued in PA

Legal business name

MAINLINE MEDICAL ASSOCIATES, INC.

Practice address

792 Gallitzin Rd
Cresson, PA 16630-2213

Phone

(814) 886-8161

NPI assigned

Feb 9, 2007

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenny Heine

Title

Dir. of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Tax ID family

Mainline Medical Associates Inc2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mainline Medical Associates, Inc.

  • Non-Pharmacy Dispensing Site
  • Altoona, PA
  • NPI 1366583700
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dawn Repko

  • Family Medicine Physician
  • Cresson, PA
  • NPI 1710957097
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1205977642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705",
            "telephone_number": "858-625-2990",
            "fax_number": "858-625-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 GALLITZIN RD",
            "city": "CRESSON",
            "state": "PA",
            "postal_code": "166302213",
            "telephone_number": "814-886-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIR. OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD023791E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie Lynn Lewis, PA-C
• Brad L Lewis, PAC
• Briana Erin Lidwell
• Gregory Lute
• Mainline CPL, LLC
• Liva R Marasco, PA-C
• Amber Rose Maruca
• Mastrine Eye Care
• Ashley Marie Mastrine, O.D.
• Mending Hearts Counseling and Consultation Services LLC

• Non-Pharmacy Dispensing Site in Cresson, PA
• Providers in Cresson, PA by specialty
• Non-Pharmacy Dispensing Site in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.