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General NPI Number Information
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NPI Number | 1770583908
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Entity Type | Organization
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Legal Business Name | BETHANY HOSPICE SERVICES OF WESTERN PENNSYLVANIA, LLC
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 12/16/2013
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Provider Practice Location Address
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Address Line | 875 GREENTREE RD STE 100 SIX PARKWAY CENTER
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City | PITTSBURGH
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State | PA
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Zip | 15220-3508
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Country | US
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Telephone | 412-921-2209
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Fax | 412-921-2552
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Provider Business Mailing Address
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Address Line | 875 GREENTREE RD STE 100 SIX PARKWAY CENTER
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City | PITTSBURGH
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State | PA
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Zip | 15220-3508
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Country | US
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Telephone | 412-921-2209
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Fax | 412-921-2552
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DIANE L MEAD
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Credential | RN, BSN
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Telephone | 412-921-2209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 16641601
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License Number State | PA
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