Provider Demographics
NPI:1184670267
Name:SCHOOL DISTRICT OF PITTSBURGH
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF PITTSBURGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. ACCOUNTANT MEDICAID OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:C
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-622-3803
Mailing Address - Street 1:341 S BELLEFIELD AVE
Mailing Address - Street 2:ROOM 301
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3552
Mailing Address - Country:US
Mailing Address - Phone:412-622-3801
Mailing Address - Fax:412-622-3802
Practice Address - Street 1:341 S BELLEFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3552
Practice Address - Country:US
Practice Address - Phone:412-622-3801
Practice Address - Fax:412-622-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001339950006Medicaid