Provider Demographics
NPI:1205839156
Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Other - Org Name:FORBES HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:412-578-6987
Mailing Address - Street 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-325-7200
Mailing Address - Fax:412-578-7373
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-325-7200
Practice Address - Fax:412-325-7303
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST PENN ALLEGHNEY HEALTH SYSTEM. OMC/
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-24
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA714105251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200086Medicaid
PA397141AMedicare Oscar/Certification