Provider Demographics
NPI:1033127535
Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Other - Org Name:TRI-COUNTY CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:THANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-226-3345
Mailing Address - Street 1:2781 LEECHBURG RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3138
Mailing Address - Country:US
Mailing Address - Phone:724-226-3345
Mailing Address - Fax:724-226-2415
Practice Address - Street 1:2781 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3138
Practice Address - Country:US
Practice Address - Phone:724-225-3345
Practice Address - Fax:724-226-2415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200012Medicaid
OH2879596Medicaid
WV3810004774Medicaid
PA000803Medicare PIN
PA1007277200012Medicaid
WV3810004774Medicaid