Provider Demographics
NPI:1346578747
Name:NIGHTINGALE HOME HEALTHCARE OF WESTERN PENNSYLVANIA, INC.
Entity Type:Organization
Organization Name:NIGHTINGALE HOME HEALTHCARE OF WESTERN PENNSYLVANIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEV
Authorized Official - Middle Name:ANUROOP
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:1036 S RANGELINE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2544
Mailing Address - Country:US
Mailing Address - Phone:866-334-7777
Mailing Address - Fax:317-569-0140
Practice Address - Street 1:201 PENN CENTER BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5435
Practice Address - Country:US
Practice Address - Phone:866-334-7777
Practice Address - Fax:866-878-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03480501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022815020001Medicaid
PA398098Medicare Oscar/Certification