Healthcare Provider Details

I. General information

NPI: 1881670453
Provider Name (Legal Business Name): UPMC JAMESON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 WILMINGTON AVE
NEW CASTLE PA
16105-2516
US

IV. Provider business mailing address

1211 WILMINGTON AVE
NEW CASTLE PA
16105-2516
US

V. Phone/Fax

Practice location:
  • Phone: 724-656-4025
  • Fax: 724-656-4260
Mailing address:
  • Phone: 724-656-4008
  • Fax: 724-656-4171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number101202
License Number StatePA

VIII. Authorized Official

Name: MR. JAMES ROBERT AUBEL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 724-656-4008