Provider Demographics
NPI:1407126881
Name:UPMC COMMUNITY MEDICINE INC
Entity Type:Organization
Organization Name:UPMC COMMUNITY MEDICINE INC
Other - Org Name:FRANKLIN SURGICAL GROUP-UPMC
Other - Org Type:Other Name
Authorized Official - Title/Position:SR.DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0943
Mailing Address - Street 1:150 PROSPECT AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-2542
Mailing Address - Country:US
Mailing Address - Phone:814-437-6188
Mailing Address - Fax:814-432-7663
Practice Address - Street 1:150 PROSPECT AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-2542
Practice Address - Country:US
Practice Address - Phone:814-437-6188
Practice Address - Fax:814-432-7663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042490Medicare PIN