Healthcare Provider Details

I. General information

NPI: 1790235893
Provider Name (Legal Business Name): PITTSBURGH MERCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S 9TH ST
PITTSBURGH PA
15203-1266
US

IV. Provider business mailing address

330 S 9TH ST
PITTSBURGH PA
15203-1266
US

V. Phone/Fax

Practice location:
  • Phone: 412-488-2264
  • Fax: 412-488-4097
Mailing address:
  • Phone: 412-488-2264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009130
License Number StatePA

VIII. Authorized Official

Name: AMANDA ANGLUM
Title or Position: PATIENT ACCOUNTS DIRECTOR
Credential:
Phone: 412-697-0712