1700831401 NPI number — CENTER FOR EMERGENCY MEDICINE OF WESTERN PENNSYLVANIA

Table of content: (NPI 1700831401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700831401 NPI number — CENTER FOR EMERGENCY MEDICINE OF WESTERN PENNSYLVANIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR EMERGENCY MEDICINE OF WESTERN PENNSYLVANIA
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:
STAT MEDEVAC
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:
1700831401
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HOT METAL ST
Provider Second Line Business Mailing Address:
QUANTUM 1 - 3RD FLOOR, ROOM 376
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15203-2348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-432-5007
Provider Business Mailing Address Fax Number:
412-864-0197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 ALLEGHENY COUNTY AIRPORT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST MIFFLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15122-2673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-432-5007
Provider Business Practice Location Address Fax Number:
412-864-0197
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOODMAN
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
FRANK
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
412-432-5007

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  03085 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416A0800X , with the licence number: 03085 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416A0800X , with the licence number: 10774 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 03085 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1700831401 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0010996990004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009020381 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1012088 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4582437 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100006540 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01872540 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20001746 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590008485 . This is a "PALMETTA GBA MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0196339 00 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0677996 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0134147 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0146055000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 184710550 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 912570100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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