Healthcare Provider Details

I. General information

NPI: 1942307251
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF PITTSBURGH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16269 CONNEAUT LAKE ROAD
MEADVILLE PA
16335
US

IV. Provider business mailing address

11524 AIRPORT RD STE 1
MEADVILLE PA
16335-3800
US

V. Phone/Fax

Practice location:
  • Phone: 814-333-1293
  • Fax: 814-336-5666
Mailing address:
  • Phone: 814-333-1293
  • Fax: 814-336-5666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number77360500
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. THOMAS DIMARCO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 614-436-9404