1780685602 NPI number — DEANNA SCHWEIKERT PAC

Table of content: DEANNA SCHWEIKERT PAC (NPI 1780685602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780685602 NPI number — DEANNA SCHWEIKERT PAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWEIKERT
Provider First Name:
DEANNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PAC
Provider Gender Code:
F

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:
1780685602
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
380 WEST CHESTNUT STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15301-4657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-228-1414
Provider Business Mailing Address Fax Number:
724-228-8579

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9104 BABCOCK BLVD
Provider Second Line Business Practice Location Address:
STE 5113
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15237-5818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-321-1989
Provider Business Practice Location Address Fax Number:
740-266-1201
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  103506 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , with the licence number: MA053064 , 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: 0480730001 . This is a "CIGNA GOVERMENT DMERC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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