1467537738 NPI number — UPMC MUNCY

Table of content: (NPI 1467537738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467537738 NPI number — UPMC MUNCY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC MUNCY
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:
Provider Other Organization Name Type Code:
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:
1467537738
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GRANT STREET US STEEL TOWER
Provider Second Line Business Mailing Address:
59TH FLOOR C/O RENEE JOHNSON
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15219-2740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-623-6303
Provider Business Mailing Address Fax Number:
412-623-6369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 E WATER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNCY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17756-8828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-546-8282
Provider Business Practice Location Address Fax Number:
570-326-8601
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STOCKHAUSEN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
412-578-9592

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  134301 , 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: 20020966 . This is a "AMERIHEALTH HMO AMER PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 391301 . This is a "HEALTH AMERICA PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 391301 . This is a "BLUE CROSS PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1004905 . This is a "KEYSTONE MERCY HEALTH PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007607800006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 309502 . This is a "BLACK LUNG PROGRAM PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 058074 . This is a "FIRST PRIORITY HEALTH PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 391301 . This is a "HEALTH ASSURANCE PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 391301 . This is a "AETNA PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 29430 . This is a "GEISINGER HEALTH PLAN PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000111 . This is a "AMERIHEALTH ADMINSTR PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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