Provider Demographics
NPI:1326120908
Name:ST. CLAIR MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ST. CLAIR MEMORIAL HOSPITAL
Other - Org Name:ST. CLAIR HOSPITAL INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-344-6600
Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-344-6600
Mailing Address - Fax:412-572-6923
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-344-6600
Practice Address - Fax:412-572-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415531L332BP3500X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007552060011Medicaid
PA1040020001Medicare NSC