NPIMap

Organization Active NPI

Ehpp Chestnut Ridge LLC

  • Non-Pharmacy Dispensing Site
  • Latrobe, PA
National Provider Identifier
1992940068
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD039198 Issued in PA
Legal business name
EHPP CHESTNUT RIDGE LLC
Practice address
911 Ligonier St
101
Latrobe, PA 15650-1805
Phone
(725) 537-8518
NPI assigned
Dec 3, 2008
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD039198 PA Primary

Addresses

Primary practice location

911 Ligonier St
101
Latrobe, PA 15650-1805

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Excela Chestnut Ridge Latrobe Ligonier Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ehpp Chestnut Ridge LLC8 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1992940068",
    "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": "911 LIGONIER ST",
            "address_2": "101",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501805",
            "telephone_number": "725-537-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EHPP CHESTNUT RIDGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-12-03",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD039198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excela Chestnut Ridge Latrobe Ligonier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.