Provider Demographics
NPI:1245220326
Name:UPMC HAMOT
Entity Type:Organization
Organization Name:UPMC HAMOT
Other - Org Name:GREAT LAKES HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-877-6340
Mailing Address - Street 1:1700 PEACH ST
Mailing Address - Street 2:SUITE 244
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-2134
Mailing Address - Country:US
Mailing Address - Phone:814-877-6120
Mailing Address - Fax:814-877-6032
Practice Address - Street 1:1700 PEACH ST
Practice Address - Street 2:SUITE 244
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2134
Practice Address - Country:US
Practice Address - Phone:814-877-6120
Practice Address - Fax:814-877-6032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC HAMOT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-28
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007286570044Medicaid
PA1007286570044Medicaid