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General NPI Number Information
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NPI Number | 1972672921
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Entity Type | Organization
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Legal Business Name | VA PITTSBURGH HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | UNIVERSITY DR C
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City | PITTSBURGH
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State | PA
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Zip | 15240
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Country | US
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Telephone | 412-688-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1153 OLD FARM RD
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City | LAWRENCE
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State | PA
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Zip | 15055-1028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL-SURGICAL CNS
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Name | ANECIA THIBODEAU
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Credential | R.N.
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Telephone | 412-688-6648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | RN527400L
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License Number State | PA
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