1013902964 NPI number — BALDWIN EMERGENCY MEDICAL SERVICE

Table of content: (NPI 1013902964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013902964 NPI number — BALDWIN EMERGENCY MEDICAL SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BALDWIN EMERGENCY MEDICAL SERVICE
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:
1013902964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 READSHAW WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15236-2769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-884-0666
Provider Business Mailing Address Fax Number:
412-884-5717

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 READSHAW WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15236-2769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-884-0666
Provider Business Practice Location Address Fax Number:
412-884-5717
Provider Enumeration Date:
09/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WIEDENHEFT
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
ELAINE
Authorized Official Title or Position:
TREASURER/OFFICE MANAGER
Authorized Official Telephone Number:
412-884-0666

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  05150 , 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: 000884710003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 103846 . This is a "UPMC FOR YOU" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 112017801 . This is a "BEST HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1010752 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 604002200 . This is a "U.S. DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590005344 . This is a "PALMETTO RR MEDICARE" identifier . This identifiers is of the category "OTHER".




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