1770551673 NPI number — STEEL CITY ORTHOPEDIC ASSOCIATES LTD

Table of content: (NPI 1770551673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770551673 NPI number — STEEL CITY ORTHOPEDIC ASSOCIATES LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEEL CITY ORTHOPEDIC ASSOCIATES LTD
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:
1770551673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 WATERDAM PLAZA DR
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
MC MURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-5411
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-941-3886
Provider Business Mailing Address Fax Number:
724-941-7818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-4261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-228-7811
Provider Business Practice Location Address Fax Number:
724-228-9801
Provider Enumeration Date:
03/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
THEIS
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-941-3886

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  MD012953E , 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: 00006816920001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CL0562 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".