1770555898 NPI number — THREE RIVERS CARDIAC INSTITUTE INC.

Table of content: (NPI 1770555898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770555898 NPI number — THREE RIVERS CARDIAC INSTITUTE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THREE RIVERS CARDIAC INSTITUTE 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:
1770555898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 ONEIDA VALLEY RD STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUTLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16001-2239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-282-4370
Provider Business Mailing Address Fax Number:
724-431-2288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
127 ONEIDA VALLEY RD STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUTLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-282-4370
Provider Business Practice Location Address Fax Number:
724-431-2288
Provider Enumeration Date:
02/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TREW
Authorized Official First Name:
SALLY
Authorized Official Middle Name:
JOANNE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
724-431-4328

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 135243 . This is a "HIGHMARK/KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 69142 . This is a "THREE RIVERS HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 77789 . This is a "US HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CB0150 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1002625 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6946180004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77789 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 611403 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: CB0150 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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