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Ehpp Chestnut Ridge LLC — NPI 1558508267, Latrobe, PA | NPI Central

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NPI 1558508267

OrganizationActive

Ehpp Chestnut Ridge LLC

NPI 1558508267 · Non-Pharmacy Dispensing Site · Latrobe, PA

Provider details

NPI number: 1558508267
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Organization subpart: Yes
Authorized official: Kenny Heine, Director of Operations(858) 625-2990
License: MD033840 (PA)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense MD033840 (PA)
Suppliers

Practice location

501 Weldon St

Latrobe, PA 15650-1520

Phone: (724) 537-0733

Approximate (ZIP-level) locationGet directions

More PA providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Other names (DBA / former)

Doing business as: Excela Chestnut Ridge Weldon Street

Registry dates

Enumerated: 2009-01-16
Last updated: 2012-10-23

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.