BACK MOUNTAIN PEDIATRICS (NPI# 1063621233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063621233 |
| Entity Type | Organization |
| Organization Name | BACK MOUNTAIN PEDIATRICS |
| Practice Address |
550 Memorial Highway Dallas PA 18612 |
| Mailing Address |
550 Memorial Highway Suite 1 Dallas PA 18612 |
| Practice Telephone | 5706757955 |
| Practice Fax Number | 5706757882 |
| Mailing Telephone | 5706757955 |
| Mailing Fax Number | 5706757882 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOAN E GREULICK (OWNER) |
| Authorized Official Telephone | 5706757955 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 291U00000X | Clinical Medical Laboratory | 022874 | PA | Laboratories |
| X | 208000000X | Pediatrics | MD024845E | PA | Allopathic & Osteopathic Physicians |
| Street Address |
550 MEMORIAL HIGHWAY |
| City | DALLAS |
| State | PA |
| Zip Code | 18612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487009882 | Jacqueline Patricia O'brien | Occupational Therapist | 345 Lake Louise Rd, Dallas, PA 18612 | 2016-05-04 |
| 1164772927 | Katie M Ferguson | Pharmacist | 26 Dallas Shopping Center Memorial Highway, Dallas, PA 18612 | 2012-09-19 |
| 1619235892 | Crista Zern | Physical Therapist | 4 East Center Hill Road, Dallas, PA 18612 | 2012-04-25 |
| 1336423631 | Angela Mary Evans | Nurse Practitioner | 301 Lake Street, Misericordia University's Health & Wellness Center, Dallas, PA 18612 | 2011-10-05 |
| 1376835868 | Peter Frederick Casterline | Surgery | 5 Old Well Lane, Dallas, PA 18612 | 2011-05-03 |
| 1336386051 | Judy A Williams | Speech-Language Pathologist | 368 Tioga Avenue, Kingston, PA 18612 | 2009-01-16 |
| 1013195015 | Joseph John Kowalski | Psychiatry & Neurology | 2 Birch Hill Lane, Dallas, PA 18612 | 2008-02-01 |
| 1760699177 | Leonard M Evans | Internal Medicine | 1806 Country Club Apartments, Dallas, PA 18612 | 2007-05-16 |
| 1417170549 | Clem-mar House, Inc. | Substance Abuse Rehabilitation Facility | 2860 State Route 309, Dallas, PA 18612 | 2007-04-10 |
| 1407985179 | Thomas D Connors | Specialist/Technologist | 2000 Conyngham Ave., Dallas, PA 18612 | 2007-03-05 |
| Find all providers in zip 18612 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951923 | Logos Clinical Laboratory LLC | Clinical Medical Laboratory | 7920 Belt Line Rd Ste 200, Dallas, TX 75254-8653 | 2020-10-26 |
| 1669079208 | Exova Diagnostics LLC | Clinical Medical Laboratory | 9884 Monroe Dr, Dallas, TX 75220-1506 | 2020-10-07 |
| 1285248153 | Pinnacle Laboratories LLC | Clinical Medical Laboratory | 7515 Greenville Ave Ste 900, Dallas, TX 75231-3851 | 2020-09-08 |
| 1972111383 | Renuvix Medical Solutions | Clinical Medical Laboratory | 18383 Preston Rd Ste 250, Dallas, TX 75252-5471 | 2020-07-21 |
| 1851917207 | Greystone Diagnostics, LLC | Clinical Medical Laboratory | 10042 Monroe Dr, Dallas, TX 75229-5703 | 2020-06-22 |
| 1902425440 | Summit Clinical Laboratory, LLC | Clinical Medical Laboratory | 17742 Preston Rd # 205, Dallas, TX 75252-6199 | 2020-04-14 |
| 1083264543 | Paradigm West LLC | Clinical Medical Laboratory | 2110 Research Row Ste 100, Dallas, TX 75235-2520 | 2019-09-17 |
| 1316506025 | Molecular Innovations Neo-designs Laboratories, LLC | Clinical Medical Laboratory | 839 W. Commerce, Dallas, TX 75208 | 2019-06-07 |
| 1548826043 | Confirm Laboratory LLC | Clinical Medical Laboratory | 2828 Forest Ln Ste 1119, Dallas, TX 75234-7500 | 2019-05-10 |
| 1245740208 | Precision Hr of Texas | Clinical Medical Laboratory | 2263 Valdina St Ste 100-b, Dallas, TX 75207-6125 | 2017-10-04 |
| Find all providers in DALLAS | ||||
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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.