Healthcare Provider Details

I. General information

NPI: 1790064467
Provider Name (Legal Business Name): INTEGRATED CORPORATE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2011
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 SIDNEY ST STE 800
PITTSBURGH PA
15203-2176
US

IV. Provider business mailing address

2403 SIDNEY ST STE 800
PITTSBURGH PA
15203-2176
US

V. Phone/Fax

Practice location:
  • Phone: 412-481-1644
  • Fax: 412-481-6300
Mailing address:
  • Phone: 412-481-1644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-230861L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMD-024673-E
License Number StatePA

VIII. Authorized Official

Name: ELIZABETH SULLIVAN
Title or Position: PRESIDENT
Credential: BSN-MPM
Phone: 412-481-1644