1194734798 NPI number — UPMC MCKEESPORT

Table of content: (NPI 1194734798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194734798 NPI number — UPMC MCKEESPORT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC MCKEESPORT
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:
1194734798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2023
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:
15250-8007
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:
1500 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15132-2422
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:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TIMMONS
Authorized Official First Name:
LAURENE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
412-664-6781

Provider Taxonomy Codes

  • Taxonomy code: 276400000X , with the licence number:  707299 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0006490690 . This is a "VALUE OPTIONS NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 390002 . This is a "HEALTHAMERICA NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0004839 . This is a "UMWVA NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000021 . This is a "GATEWAY NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 46 . This is a "UPMC HEALTH PLAN NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0080001 . This is a "AETNA US HEALTHCARE NUMBE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 030796100 . This is a "STATE WV OH WC NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000060306 . This is a "MEDPLUS NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0008 . This is a "HIGHMARK PROVIDER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007643400014 . This is a "ION HEALTHCARE NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4196007 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01073330 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5784263 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0004847 . This is a "UMWVA NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0101249 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10076434000014 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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