1316376148 NPI number — SOUTH HILLS REHAB ASSOC. INC.

Table of content: (NPI 1316376148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316376148 NPI number — SOUTH HILLS REHAB ASSOC. INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH HILLS REHAB ASSOC. 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:
1316376148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
575 COAL VALLEY RD
Provider Second Line Business Mailing Address:
SUITE 277
Provider Business Mailing Address City Name:
JEFFERSON HILLS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15025-3730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-469-7722
Provider Business Mailing Address Fax Number:
412-469-7721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 OXFORD DR
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
BETHEL PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15102-1823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-833-3934
Provider Business Practice Location Address Fax Number:
412-469-7721
Provider Enumeration Date:
11/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MEHTA
Authorized Official First Name:
RAJESH
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
412-469-7722

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  MD052535L , 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: 1007508090003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1398027 . This is a "BLUE SHIELD GROUP ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1526169 . This is a "GATEWAY GROUP ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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