French Creek Internal Medicine

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS012833 Issued in PA

Legal business name

FRENCH CREEK INTERNAL MEDICINE

Practice address

765 Liberty St
307 - 3Rd Floor
Meadville, PA 16335-2566

Phone

(814) 336-1140

NPI assigned

Aug 7, 2007

Organization subpart

Yes

Parent organization

MEDVANTX, INCAs 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

VP of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Tax ID family

Primary Care Services2 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.

• Robert a Bazylak, M.D.

  • Family Medicine Physician
  • Conneaut Lake, PA
  • NPI 1306382270
  NPD tax ID

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1750572467",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LIBERTY ST",
            "address_2": "307 - 3RD FLOOR",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352566",
            "telephone_number": "814-336-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRENCH CREEK INTERNAL MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2007-08-07",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS012833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerald Lynn Foust, PA-C
• Jason C. Fowler, PA-C
• Keri Fratarcangeli, LCSW
• French Creek Dental Group
• French Creek Eyecare, LLC
• French Creek Pain Management,PC
• Philip A Frndak, D.O.
• Carissa Fucci, LPC
• Damian J. Gallina, BA, BS, RPH
• Jessie Ganjoo, MD

• Non-Pharmacy Dispensing Site in Meadville, PA
• Providers in Meadville, 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 Mar 30, 2015; 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.