Healthcare Provider Details

I. General information

NPI: 1083587547
Provider Name (Legal Business Name): WEST PENN ALLEGHENY HEALTH SYSTEM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4090 JACKSONS POINTE CT STE A
ZELIENOPLE PA
16063-2838
US

IV. Provider business mailing address

4090 JACKSONS POINTE CT STE A
ZELIENOPLE PA
16063-2838
US

V. Phone/Fax

Practice location:
  • Phone: 878-332-4450
  • Fax: 724-419-2537
Mailing address:
  • Phone: 878-332-4450
  • Fax: 724-419-2537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANDREW TISCH
Title or Position: DIRECTOR REIMBURSEMENT
Credential:
Phone: 412-330-6062