MEDICARE: PYRAMID HEALTHCARE

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	447027	PA
2	324500000X	Substance Abuse Rehabilitation Facility	447027	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811018898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PYRAMID HEALTHCARE

Provider Business Mailing Address
First Line	:	1894 OLD ROUTE 220 N
Second Line	:	P.O. BOX 967
City	:	DUNCANSVILLE
State	:	PA
Zip	:	16635-8304
Country	:	US
Telephone Number	:	814-940-0407
Fax Number	:	814-941-0574

Provider Business Practice Location Address
First Line	:	3893 WEST MAIN STREET
Second Line	:
City	:	BELLEVILLE
State	:	PA
Zip	:	17004-9252
Country	:	US
Telephone Number	:	717-935-5400
Fax Number	:	717-935-5413

Authorized Official
Title or Position	:	CEO
Name	:	MR. JASON HENDRICKS
Credential	:
Telephone Number	:	814-940-0407

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	04/10/2024

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Directions to “PYRAMID HEALTHCARE ” Practice Location

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