Healthcare Provider Details

I. General information

NPI: 1841384765
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF PITTSBURGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 GRANDE MEADOWS DR STE 203
BRIDGEPORT WV
26330-9035
US

IV. Provider business mailing address

37 GRANDE MEADOWS DR STE 203
BRIDGEPORT WV
26330-9035
US

V. Phone/Fax

Practice location:
  • Phone: 304-592-3538
  • Fax: 304-592-0817
Mailing address:
  • Phone: 304-592-3538
  • Fax: 304-592-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number022134
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS DIMARCO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 614-436-9404