Provider Demographics
NPI:1073599643
Name:UPMC JAMESON
Entity Type:Organization
Organization Name:UPMC JAMESON
Other - Org Name:JAMESON HOSPICE OF LAWRENCE COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:AUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-656-4008
Mailing Address - Street 1:1211 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-2516
Mailing Address - Country:US
Mailing Address - Phone:724-656-4008
Mailing Address - Fax:724-656-4171
Practice Address - Street 1:1000 S MERCER ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-4672
Practice Address - Country:US
Practice Address - Phone:724-652-8847
Practice Address - Fax:724-656-6193
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC JAMESON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-15
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16441601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000021890021Medicaid
PA1000021890021Medicaid