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General NPI Number Information
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NPI Number | 1942506258
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Entity Type | Organization
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Legal Business Name | 2900 JOHNSON STREET OPERATING COMPANY, LP
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2900 JOHNSON ST
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City | ALIQUIPPA
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State | PA
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Zip | 15001-1146
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Country | US
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Telephone | 724-857-9301
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Fax |
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Provider Business Mailing Address
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Address Line | 500 SENECA ST STE 100
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City | BUFFALO
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State | NY
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Zip | 14204-1963
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Country | US
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Telephone | 716-361-6636
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR REVENUE CYCLE MGMT
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Name | KIMBERLY KENWORTHY
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Credential |
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Telephone | 716-361-6636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 442890
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License Number State | PA
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