1053471656 NPI number — UPMC PRESBYTERIAN SHADYSIDE

Table of content: (NPI 1053471656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053471656 NPI number — UPMC PRESBYTERIAN SHADYSIDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC PRESBYTERIAN SHADYSIDE
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:
1053471656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 382007
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:
15251-8007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-432-5500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 LOTHROP ST
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:
15213-2536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-432-5500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WEINER
Authorized Official First Name:
JARED
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
412-864-7000

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 98138 . This is a "CHRONIC RENAL NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000019040151 . This is a "ION HEALTHCARE NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0013 . This is a "PUH RENAL NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".