Conneaut Valley Health Center Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

OS011018L Issued in PA

Legal business name

CONNEAUT VALLEY HEALTH CENTER INC.

Practice address

906 Washington St
Conneautville, PA 16406

Phone

(814) 373-2276

Fax

(814) 587-2918

NPI assigned

Jul 19, 2006

Last updated

Apr 16, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Renato J. Suntay

Title

Chief Financial Officer

Phone

(814) 373-2449

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1558380469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 WATER ST",
            "address_2": "SECOND FLOOR",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353465",
            "telephone_number": "814-373-2449",
            "fax_number": "814-373-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 WASHINGTON ST",
            "city": "CONNEAUTVILLE",
            "state": "PA",
            "postal_code": "16406",
            "telephone_number": "814-373-2276",
            "fax_number": "814-587-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNEAUT VALLEY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "SUNTAY",
        "authorized_official_first_name": "RENATO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "814-373-2449",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS011018L",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "PA",
            "license": "OS011018L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007230030001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "191386",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CE7746",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Marie Anderson, DPM
• Cindy Billingsley
• David Brownstein, D.M.D.
• David A. Buchina, D.M.D.
• Kristin Carter, PTA, CLT-LANA
• Conneaut Valley Health Center Podiatry
• Conneaut Valley Health Center, Inc. (Valley Dental Center)
• Wesley C Davis, DPT
• Zachery Faust, DC
• Fellows Club Volunteer Fire Dept (Fellows Club Ambulance Service)

• Rural Health Clinic/Center in Conneautville, PA
• Providers in Conneautville, PA by specialty
• Rural Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.