Provider Demographics
NPI:1225146228
Name:EVERETT & HURITE OPHTHALMIC ASSOCIATION
Entity Type:Organization
Organization Name:EVERETT & HURITE OPHTHALMIC ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-586-1217
Mailing Address - Street 1:1835 FORBES AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5835
Mailing Address - Country:US
Mailing Address - Phone:412-288-0885
Mailing Address - Fax:412-281-1926
Practice Address - Street 1:1835 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5835
Practice Address - Country:US
Practice Address - Phone:412-288-0885
Practice Address - Fax:412-281-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010058160022Medicaid
PA0010058160022Medicaid
WV9264351Medicare PIN
PA0577500002Medicare NSC