1356331235 NPI number — COUNTY OF ALLEGHENY

Table of content: (NPI 1356331235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356331235 NPI number — COUNTY OF ALLEGHENY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ALLEGHENY
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:
1356331235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
955 RIVERMONT DR
Provider Second Line Business Mailing Address:
ATTN: CHIEF FISCAL OFFICER
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15207-1347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-422-6050
Provider Business Mailing Address Fax Number:
412-422-6966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 9TH ST
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:
15132-3952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-422-6050
Provider Business Practice Location Address Fax Number:
412-422-6966
Provider Enumeration Date:
10/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
POLINAK
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
412-422-6050

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  364702 , 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: 1007463050048 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007411200008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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