Provider Demographics
NPI:1205390325
Name:PYRAMID HEALTH CARE INC.
Entity Type:Organization
Organization Name:PYRAMID HEALTH CARE INC.
Other - Org Name:PYRAMID HEALTHCARE INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-940-0407
Mailing Address - Street 1:100 UPPER DEMUNDS RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-8811
Mailing Address - Country:US
Mailing Address - Phone:570-761-6210
Mailing Address - Fax:570-255-5850
Practice Address - Street 1:100 UPPER DEMUNDS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-8811
Practice Address - Country:US
Practice Address - Phone:570-761-6210
Practice Address - Fax:570-255-5850
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PYRAMID HEALTH CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA407073OtherSTATE LICENSE NUMBER