Healthcare Provider Details

I. General information

NPI: 1063476067
Provider Name (Legal Business Name): UPMC/HVHS CANCER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CORAOPOLIS HEIGHTS RD
MOON TOWNSHIP PA
15108-4316
US

IV. Provider business mailing address

2 HOT METAL ST QUANTUM ONE N430
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 412-604-2020
  • Fax: 412-604-2046
Mailing address:
  • Phone: 412-432-7706
  • Fax: 412-432-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLES E BOGOSTA
Title or Position: VICE PRESIDENT
Credential:
Phone: 412-692-2451