Provider Demographics
NPI:1417940487
Name:INTERIM HEALTHCARE OF WESTERN PENNSYLVANIA INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF WESTERN PENNSYLVANIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEINDL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-375-9615
Mailing Address - Street 1:127 N BRADY ST
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2227
Mailing Address - Country:US
Mailing Address - Phone:814-375-9615
Mailing Address - Fax:814-375-1362
Practice Address - Street 1:127 N BRADY ST
Practice Address - Street 2:SUITE B
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2257
Practice Address - Country:US
Practice Address - Phone:814-375-9615
Practice Address - Fax:814-375-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10000084500008Medicaid
PA008518OtherCLEAR-JEFF MHMR (HS)
PA1065OtherBLUE CROSS
PA008509OtherCLEAR-JEFF MHMR (EI)
PA1000008450005Medicaid
PA1000008450013Medicaid
PA1511022Medicaid
PA1000008450010Medicaid
PA61-34OtherVENANGO COUNTY MH/MR
PA1000008450012Medicaid
PA105044Medicaid
PA008501OtherCLEAR-JEFF MHMR (HS)
PA1065OtherBLUE CROSS
PA1000008450010Medicaid