Provider Demographics
NPI:1003991555
Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC
Entity Type:Organization
Organization Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC
Other - Org Name:FORBES REGIONAL PATHOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BEDETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-858-2567
Mailing Address - Street 1:PO BOX 931618
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-1742
Mailing Address - Country:US
Mailing Address - Phone:412-323-4402
Mailing Address - Fax:412-323-4418
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-2567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200091Medicaid
PADG4352OtherPALMETTO GBA RAILROAD MEDICARE
PA1945759OtherHIGHMARK BLUE SHIELD
PA1945759OtherHIGHMARK BLUE SHIELD