MEDICARE: LITTLE SISTERS OF THE POOR OF THE STATE OF PENNSYLVANIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	340302	PA
2	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528138856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE SISTERS OF THE POOR OF THE STATE OF PENNSYLVANIA

Provider Business Mailing Address
First Line	:	1028 BENTON AVENUE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-1607
Country	:	US
Telephone Number	:	412-307-1100
Fax Number	:	412-307-1104

Provider Business Practice Location Address
First Line	:	1028 BENTON AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-1607
Country	:	US
Telephone Number	:	412-307-1100
Fax Number	:	412-307-1104

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUDITH MEREDITH
Credential	:
Telephone Number	:	412-307-1117

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/10/2023

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Directions to “LITTLE SISTERS OF THE POOR OF THE STATE OF PENNSYLVANIA ” Practice Location

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