MEDICARE: MOUNT CARMEL HEALTH SYSTEM

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	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1942697032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT CARMEL HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	1430 SUMMIT ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-2632
Country	:	US
Telephone Number	:	970-690-0258
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 SUMMIT ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-2632
Country	:	US
Telephone Number	:	970-690-0258
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM ADMINISTRATOR
Name	:	LILLIAN BADURINA
Credential	:	C-TAGME
Telephone Number	:	614-234-5983

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	04/16/2015

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