Healthcare Provider Details

I. General information

NPI: 1225033392
Provider Name (Legal Business Name): LAWSON NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3704
US

IV. Provider business mailing address

540 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3704
US

V. Phone/Fax

Practice location:
  • Phone: 412-466-1125
  • Fax: 412-466-1971
Mailing address:
  • Phone: 412-466-1125
  • Fax: 412-466-1971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number024002
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0015937270002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier0980
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS

VIII. Authorized Official

Name: MS. SARAH A MALONI
Title or Position: ANHA
Credential: LPN
Phone: 412-466-1125