1033151584 NPI number — GMA-UNIONTOWN INC

Table of content: (NPI 1033151584)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033151584 NPI number — GMA-UNIONTOWN INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GMA-UNIONTOWN INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAUREL RIDGE CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033151584
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 E STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNETT SQUARE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19348-3109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-925-4436
Provider Business Mailing Address Fax Number:
610-925-4351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 HICKLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-4350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-437-9871
Provider Business Practice Location Address Fax Number:
724-438-8842
Provider Enumeration Date:
06/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DROPESKEY
Authorized Official First Name:
JANE
Authorized Official Middle Name:
Authorized Official Title or Position:
CORPORATE MANAGER
Authorized Official Telephone Number:
610-925-4231

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  381002 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12731 . This is a "ELDER HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007302520001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000395243 . This is a "MOUNTIAN STATE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 271895 . This is a "UNITED - MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 395243 . This is a "HIGHMARK - MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 924148 . This is a "AETNA-HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110775 . This is a "UNISON UNISON ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0469 . This is a "HIGHMARL - BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110775 . This is a "UNISON - MED PLUS" identifier . This identifiers is of the category "OTHER".