Provider Demographics
NPI:1114060357
Name:INTERIM HEALTHCARE OF PITTSBURGH INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF PITTSBURGH INC
Other - Org Name:INTERIM HEALTHCARE OF MOUNDSVILLE
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 1:300 W WILSON BRIDGE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2289
Mailing Address - Country:US
Mailing Address - Phone:614-436-9404
Mailing Address - Fax:614-436-2056
Practice Address - Street 1:245 JEFFERSON AVE STE 1G
Practice Address - Street 2:
Practice Address - City:MOUNDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26041-1464
Practice Address - Country:US
Practice Address - Phone:304-843-1366
Practice Address - Fax:340-843-1399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF PITTSBURGH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-15
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2556532Medicaid
OH368132Medicare ID - Type UnspecifiedMEDICARE