1841712882 NPI number — UPMC LOCK HAVEN

Table of content: (NPI 1841712882)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841712882 NPI number — UPMC LOCK HAVEN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC LOCK HAVEN
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:
LOCK HAVEN HOSPITAL
Provider Other Organization Name Type Code:
3
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:
1841712882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GRANT STREET, US STEEL TOWER, 59TH FLOOR
Provider Second Line Business Mailing Address:
C/O RENEE JOHNSON
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15219-2740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-623-6303
Provider Business Mailing Address Fax Number:
412-623-6369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 CREE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOCK HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17745-2699
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-893-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
YOST
Authorized Official First Name:
ROGER
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
814-321-3175

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 103451581-0002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 103451581-0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 103451581-0004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 103451581-0003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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