1396893152 NPI number — LIFECARE HOSPITALS OF PITTSBURGH, LLC

Table of content: (NPI 1396893152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396893152 NPI number — LIFECARE HOSPITALS OF PITTSBURGH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFECARE HOSPITALS OF PITTSBURGH, 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:
1396893152
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5340 LEGACY DR
Provider Second Line Business Mailing Address:
SUITE150
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75024-3121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-241-2100
Provider Business Mailing Address Fax Number:
469-241-5198

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 PENN AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-247-2356
Provider Business Practice Location Address Fax Number:
412-247-2333
Provider Enumeration Date:
01/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CRONIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT OF REIMBURSEMENT
Authorized Official Telephone Number:
469-241-2128

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X , with the licence number:  HO242 , 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: 001772002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0415 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".