1720180136 NPI number — WEST PENN ALLEGHENY HEALTH SYSTEM, INC.

Table of content: (NPI 1720180136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720180136 NPI number — WEST PENN ALLEGHENY HEALTH SYSTEM, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST PENN ALLEGHENY HEALTH SYSTEM, 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:
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:
1720180136
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2570 HAYMAKER RD OFC BLDG1
Provider Second Line Business Mailing Address:
SUITE 211
Provider Business Mailing Address City Name:
MONROEVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15146-3513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-858-7699
Provider Business Mailing Address Fax Number:
412-858-7696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4800 FRIENDSHIP AVE
Provider Second Line Business Practice Location Address:
SUITE N1
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15224-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-688-7580
Provider Business Practice Location Address Fax Number:
412-681-9676
Provider Enumeration Date:
09/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MENDICINO
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, PRACTICE MANAGEMENT
Authorized Official Telephone Number:
412-858-7691

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1007277200089 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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