1730158981 NPI number — UPMC HANOVER

Table of content: (NPI 1730158981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730158981 NPI number — UPMC HANOVER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC HANOVER
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:
1730158981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 HIGHLAND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HANOVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17331-2297
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-316-3711
Provider Business Mailing Address Fax Number:
717-633-2217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HANOVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17331-2297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-637-3711
Provider Business Practice Location Address Fax Number:
717-633-2217
Provider Enumeration Date:
03/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MULLER
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, FINANCE
Authorized Official Telephone Number:
717-316-2153

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 081801 , 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: 1007440330006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000056697 . This is a "UNISON (SPU)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007440330018 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1015767 . This is a "GATEWAY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 589944-01 . This is a "MARYLAND BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60770 . This is a "AMERIHEALTH MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007440330024 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1552 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6490485 . This is a "AETNA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007440330007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000082456 . This is a "UNISON (IN & OUTPATIENT)" identifier . This identifiers is of the category "OTHER".




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