1881090959 NPI number — PALLIATIVE CARE ASSOCIATES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881090959 NPI number — PALLIATIVE CARE ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PALLIATIVE CARE ASSOCIATES, LLC
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:
6
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:
1881090959
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2605 NICHOLSON RD
Provider Second Line Business Mailing Address:
BUILDING III, SUITE 220
Provider Business Mailing Address City Name:
SEWICKLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15143-8895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-816-6065
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2605 NICHOLSON RD
Provider Second Line Business Practice Location Address:
BUILDING III, SUITE 220
Provider Business Practice Location Address City Name:
SEWICKLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15143-8895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-816-6065
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
KREBS
Authorized Official First Name:
CRISTEN
Authorized Official Middle Name:
MARIA
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-816-6065

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , 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)





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