1649278730 NPI number — UPMC ALTOONA

Table of content: (NPI 1649278730)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649278730 NPI number — UPMC ALTOONA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC ALTOONA
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:
1649278730
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GRANT STREET, 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:
620 HOWARD AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16601-4899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-889-2223
Provider Business Practice Location Address Fax Number:
814-889-7808
Provider Enumeration Date:
07/12/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KLATT
Authorized Official First Name:
MONICA
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
814-889-2223

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , 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: 282N00000X , 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: 0062 . This is a "OUTPATIENT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007278290085 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: F94144462801 . This is a "ION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1008787 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0062 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60526 . This is a "INPATINET ACUTE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".