Provider Demographics
NPI:1033214903
Name:SOUTH HILLS DIAGNOSTIC & TREATMENT CENTER LP
Entity Type:Organization
Organization Name:SOUTH HILLS DIAGNOSTIC & TREATMENT CENTER LP
Other - Org Name:SOUTH HILLS ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GAROFALO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:412-232-8104
Mailing Address - Street 1:2589 BOYCE PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-4907
Mailing Address - Country:US
Mailing Address - Phone:412-838-0400
Mailing Address - Fax:412-838-0401
Practice Address - Street 1:2589 BOYCE PLAZA RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-4907
Practice Address - Country:US
Practice Address - Phone:412-838-0400
Practice Address - Fax:412-838-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094820Medicare ID - Type Unspecified