1598813214 NPI number — PITTSBURGH CHIROPRACTIC & REHABILITATION CENTER, LLC

Table of content: (NPI 1598813214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598813214 NPI number — PITTSBURGH CHIROPRACTIC & REHABILITATION CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PITTSBURGH CHIROPRACTIC & REHABILITATION CENTER, 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:
1598813214
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
470 HOME DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15275-1204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-787-7400
Provider Business Mailing Address Fax Number:
412-787-7407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
470 HOME DR
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:
15275-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-787-7400
Provider Business Practice Location Address Fax Number:
412-787-7407
Provider Enumeration Date:
01/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOPACINSKI
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
412-787-7400

Provider Taxonomy Codes

  • Taxonomy code: 111NR0400X , with the licence number:  DC007898L , 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: 453931 . This is a "BS NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1886852 . This is a "CHELE BC BS #" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
  • Identifier: 1931716 . This is a "CHELE BILLING #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1927137 . This is a "JOEL BILLING #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".