1477674828 NPI number — PYRAMID HEALTH CARE INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477674828 NPI number — PYRAMID HEALTH CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PYRAMID HEALTH CARE 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:
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:
1477674828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1894 PLANK RD
Provider Second Line Business Mailing Address:
PO BOX 967
Provider Business Mailing Address City Name:
DUNCANSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16635-8380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-940-0407
Provider Business Mailing Address Fax Number:
814-381-2798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
306 PENN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKINSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221-2134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-241-5341
Provider Business Practice Location Address Fax Number:
412-241-5394
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRICKS
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
814-940-0404

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  707233 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X , with the licence number: 707233 , 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: 1007625050077 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007625050078 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007625050076 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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