1609801976 NPI number — UPMC WILLIAMSPORT

Table of content: (NPI 1609801976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609801976 NPI number — UPMC WILLIAMSPORT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC WILLIAMSPORT
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:
WILLIAMSPORT REGIONAL MEDICAL CENTER
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:
1609801976
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GRANT ST, US STEEL TOWER, 59TH FLOOR
Provider Second Line Business Mailing Address:
C/O RENEE JOHNSON
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15219-2740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-623-6303
Provider Business Mailing Address Fax Number:
412-623-6369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17701-3198
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-321-1000
Provider Business Practice Location Address Fax Number:
570-326-8601
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
YOST
Authorized Official First Name:
ROGER
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
570-321-3175

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  234601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: 234601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X , with the licence number: 234601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 234601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: 234601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1017347 . This is a "KEYSTONE MERCY HEALTH PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 29796 . This is a "GEISINGER HEALTH PLAN PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 301400 . This is a "BLACK LUNG PROGRAM PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 390045 . This is a "HEALTH ASSURANCE PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 390045 . This is a "HEALTH AMERICA PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20007166 . This is a "AMERIHEALTH HMO AMER PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 074006 . This is a "FIRST PRIORITY HEALTH PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 390045 . This is a "AETNA PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000109 . This is a "AMERIHEALTH ADMINIST PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007548350019 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 390045 . This is a "BLUE CROSS PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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