Organization Name: | CARDIOVASCULAR SERVICES |
NPI Number: | 1013187269 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH R HANSEN (OWNER) |
Mailing Address: | 1624 Newton Ransom Blvd Clarks Summit |
State: | PA US |
Postal Code: | 184119634 |
Phone Number: | 5705867815 |
Fax Number: | |
NPI Enumeration Date: | 03/04/2008 |
NPI Last Update Date: | 03/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |