1073979860 NPI number — JOURNEY HEALTH CARE MANAGEMENT SERVICES LLC

Table of content: (NPI 1073979860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073979860 NPI number — JOURNEY HEALTH CARE MANAGEMENT SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOURNEY HEALTH CARE MANAGEMENT SERVICES LLC
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:
1073979860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/29/2016
NPI Reactivation Date:
03/07/2016

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4262 OLD WILLIAM PENN HWY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURRYSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15668-1954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-668-4444
Provider Business Mailing Address Fax Number:
724-468-0039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4262 OLD WILLIAM PENN HWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURRYSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15668-1954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-668-4444
Provider Business Practice Location Address Fax Number:
724-468-0039
Provider Enumeration Date:
01/08/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARRIGHAN
Authorized Official First Name:
LUCY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
412-400-5555

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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