1003991555 NPI number — WEST PENN ALLEGHENY HEALTH SYSTEM, INC

Table of content: (NPI 1003991555)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003991555 NPI number — WEST PENN ALLEGHENY HEALTH SYSTEM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST PENN ALLEGHENY HEALTH SYSTEM, 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:
FORBES REGIONAL PATHOLOGY
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:
1003991555
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:
PO BOX 931618
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44193-1742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-323-4402
Provider Business Mailing Address Fax Number:
412-323-4418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2570 HAYMAKER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15146-3513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-858-2567
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BEDETTI
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PATHOLOGIST
Authorized Official Telephone Number:
412-858-2567

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , 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: 1007277200091 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DG4352 . This is a "PALMETTO GBA RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1945759 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com