NPIMap

Centerville Clinics, Inc.

Organization Active NPI Clinical Medical Laboratory · Fredericktown, PA

NPI 1811978166 · NPPES record last updated Apr 1, 2008

Key facts

NPI
1811978166
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
CENTERVILLE CLINICS, INC.
Practice address
1070 Old National Pike
Fredericktown, PA 15333-2114
Phone
(724) 632-6801
Fax
(714) 632-6312
NPI assigned
Nov 11, 2005
Organization subpart
No

Authorized official

Name
Mrs. Patricia Martos
Title
Director Personnel/Finance
Phone
(724) 632-6801

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 24

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

Practitioners 98

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

View all 98

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0657071Centerville Clinics Inc Lab
1070 Old National Pike Road, Fredericktown, PA 15333		ComplianceApr 6, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051019000146 PA Part B Supplier - Independent Clinical Laboratory 7214837202 Practice locations: Fredericktown, PA

National Provider Directory

Tax ID family
Centerville Clinics Inc (66 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

1070 Old National Pike
Fredericktown, PA 15333-2114

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other identifiers

IdentifierTypeStateIssuer
1007288440027MedicaidPA

Other providers in Fredericktown, PA

All providers in Fredericktown, PA · Clinical Medical Laboratory in Pennsylvania

Sources for this page

Verify at the official NPI Registry.