Healthcare Provider Details

I. General information

NPI: 1922404748
Provider Name (Legal Business Name): ADAGIO HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 OAK ST
INDIANA PA
15701-1651
US

IV. Provider business mailing address

960 PENN AVE
PITTSBURGH PA
15222-3818
US

V. Phone/Fax

Practice location:
  • Phone: 844-328-9473
  • Fax: 724-349-4970
Mailing address:
  • Phone: 412-288-2130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: BJ LEBER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 412-288-2130