Provider Demographics
NPI:1093313926
Name:INTERIM HEALTHCARE OF PITTSBURGH, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF PITTSBURGH, INC.
Other - Org Name:INTERIM HEALTHCARE OF BRIDGEPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-436-9404
Mailing Address - Street 1:37 GRANDE MEADOWS DR STE 203
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-9035
Mailing Address - Country:US
Mailing Address - Phone:304-592-3538
Mailing Address - Fax:
Practice Address - Street 1:1111 VAN VOORHIS RD STE 2
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2737
Practice Address - Country:US
Practice Address - Phone:304-598-8900
Practice Address - Fax:304-598-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0004609000Medicaid