1609870062 NPI number — SOUTHWESTERN HEARING CARE, INC.

Table of content: (NPI 1609870062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609870062 NPI number — SOUTHWESTERN HEARING CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWESTERN HEARING 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:
1609870062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 LEWIS RUN RD
Provider Second Line Business Mailing Address:
STE 117
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15122-3057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-466-5550
Provider Business Mailing Address Fax Number:
412-466-8741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 LEWIS RUN RD
Provider Second Line Business Practice Location Address:
STE 117
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15122-3057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-466-5550
Provider Business Practice Location Address Fax Number:
412-466-8741
Provider Enumeration Date:
06/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ANGELELLI
Authorized Official First Name:
ROGER
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PRESIDENT/DIRECTOR OF AUDIOLOGY
Authorized Official Telephone Number:
412-466-5550

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  AT-000196-L , 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: 90735 . This is a "ADVANTRA PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000981818 . This is a "PIN FOR HIGHMARK B/S" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0492912 . This is a "AETNA USHEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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