Provider Demographics
NPI:1366156689
Name:MY PT EMR
Entity type:Organization
Organization Name:MY PT EMR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:POURNARAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-513-1256
Mailing Address - Street 1:384 MARA ROSE LN
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-9509
Mailing Address - Country:US
Mailing Address - Phone:903-944-9138
Mailing Address - Fax:
Practice Address - Street 1:384 MARA ROSE LN
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-9509
Practice Address - Country:US
Practice Address - Phone:903-944-9138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationGroup - Single Specialty