HERITAGE VALLEY HEALTH SYSTEM - TRISTATE MEDICAL (NPI# 1205183639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205183639 |
| Entity Type | Organization |
| Organization Name | HERITAGE VALLEY HEALTH SYSTEM - TRISTATE MEDICAL |
| Other Organization Name | HERITAGE VALLEY MEDICAL GROUP - PRIMARY CARE CENTER |
| Practice Address |
3468 Brodhead Rd Monaca PA 15061-3149 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7248570591 |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-10-25 |
| Authorized Official Name | KENNY HEINE (VP OPS) |
| Authorized Official Telephone | 8589641508 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | OS013323 | PA | Suppliers |
| Other Name | Type Code |
|---|---|
| HERITAGE VALLEY MEDICAL GROUP - PRIMARY CARE CENTER | Doing Business As Name - Organization |
| Street Address |
3468 BRODHEAD RD |
| City | MONACA |
| State | PA |
| Zip Code | 15061-3149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003814559 | Thomas Balitski | Optometrist | 3468 Brodhead Rd, Suite One, Monaca, PA 15061-3149 | 2005-07-08 |
| 1437435161 | Tri-state Medical Group, Inc. | Family Medicine | 3468 Brodhead Rd, Monaca, PA 15061-3149 | 2011-10-26 |
| 1225360183 | Beaver County Spinal Disc Center | Durable Medical Equipment & Medical Supplies | 3468 Brodhead Rd, Suite #10, Monaca, PA 15061-3149 | 2010-02-03 |
| 1639319981 | Richard A Budney Jr. | Physical Medicine & Rehabilitation | 3468 Brodhead Rd, Monaca, PA 15061-3149 | 2009-02-26 |
| 1891711537 | Balitski Vision PC | Optometrist | 3468 Brodhead Rd, Suite One, Monaca, PA 15061-3149 | 2006-07-14 |
| 1306899869 | Open Mri of Beaver Valley, Ltd | Specialist | 3468 Brodhead Rd, Monaca, PA 15061-3149 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124498910 | Ashley Lynn Bell | Physician Assistant | 3944 Brodhead Road, Suite 7b, Monaca, PA 15061 | 2015-10-06 |
| 1902193105 | Robert Martin Niedermeyer Jr. | Pharmacist | 87 Wagner Road, Monaca, PA 15061 | 2011-07-08 |
| 1033416979 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 118 Wagner Rd, Monaca, PA 15061 | 2011-02-11 |
| 1326275595 | Tri-state Medical Group, Inc. | Internal Medicine | Route 18 Wal-mart Shopping Plaza, Heritage Valley Convenient Care-monaca, Monaca, PA 15061 | 2009-06-16 |
| 1053560888 | Beth Ann Klump | Physician Assistant | 3572 Brodhead Rd., Suite 301, Monaca, PA 15061 | 2008-09-17 |
| 1376687954 | Luke E Stall | Radiology | 3582 Brodhead Rd Ste 204, Monaca, PA 15061 | 2007-02-16 |
| 1063595684 | Wal-mart Stores East, Lp | Technician/Technologist | Pa. Rt.18/wal-mart Plaza Shpg., Monaca, PA 15061 | 2006-10-24 |
| 1366533945 | Regine Lydie Bataille-gossard | Optometrist | Walmart Vision Center, Walmart Plaza Route 18, Monaca, PA 15061 | 2006-09-27 |
| 1346341708 | Richa Bajaj | Dentist | 125 Wagner Rd, Monaca, PA 15061 | 2006-09-26 |
| 1538265319 | David Walter Jaskiewicz | Optometrist | Route 18, Walmart Plaza, Monaga, PA 15061 | 2006-09-16 |
| Find all providers in zip 15061 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346380458 | Tri - State Medical Group, Inc. | Non-Pharmacy Dispensing Site | 3950 Brodhead Rd, 200, Monaca, PA 15061-3030 | 2007-02-07 |
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| 1023655602 | Dedicated Pennsylvania Holding, LLC | Non-Pharmacy Dispensing Site | 330 W Oregon Ave # 170, Philadelphia, PA 19148-4723 | 2019-12-03 |
| 1275193336 | Q Pharma Inc | Non-Pharmacy Dispensing Site | 103 Nesbitt Rd, New Castle, PA 16105-3401 | 2019-06-19 |
| 1770141491 | R&r Eyewear Imports, Inc. | Non-Pharmacy Dispensing Site | 311 W Moreland Rd, Willow Grove, PA 19090-3107 | 2019-05-29 |
| 1174089858 | Centers for Advanced Urology, LLC | Non-Pharmacy Dispensing Site | 400 Davis Dr Ste 200a, Plymouth Meeting, PA 19462-1718 | 2019-02-18 |
| 1811469760 | Dermatology and Mohs Surgery Center PC | Non-Pharmacy Dispensing Site | 920 Lawn Ave Ste 6, Sellersville, PA 18960-1560 | 2018-12-17 |
| 1437624244 | Highpoint Pain & Rehabilitation Physicians | Non-Pharmacy Dispensing Site | 2 Village Road, Horsham, PA 19044 | 2018-10-08 |
| 1649768110 | Qpharma Inc | Non-Pharmacy Dispensing Site | 20 Highland Park Dr Ste 202, Uniontown, PA 15401-8968 | 2018-04-30 |
| 1215424536 | Q Pharma Inc | Non-Pharmacy Dispensing Site | 1321 Fifth Ave Ste 1, Mckeesport, PA 15132-2403 | 2018-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.