Healthcare Provider Details

I. General information

NPI: 1912029265
Provider Name (Legal Business Name): WEST PENN ALLEGHENY HEALTH SYSTEM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3131
  • Fax: 412-359-4108
Mailing address:
  • Phone: 412-359-3131
  • Fax: 412-359-4108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number530101
License Number StatePA

VIII. Authorized Official

Name: MR. RICK FRIES
Title or Position: INTERIM VP FINANCE
Credential:
Phone: 412-359-8550