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General NPI Number Information
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NPI Number | 1952074759
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Entity Type | Organization
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Legal Business Name | CHARIOT PITTSBURGH SNF OPCO LLC
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 745 N HIGHLAND AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206-2526
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Country | US
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Telephone | 814-412-3626
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Fax |
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Provider Business Mailing Address
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Address Line | 745 N HIGHLAND AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206-2526
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Country | US
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Telephone | 814-412-3626
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Fax |
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Authorized Official
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Title or Position | DIR PROVIDER CONTRACTING
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Name | SHANA K MARK
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Credential | MBA
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Telephone | 814-277-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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