Provider Demographics
NPI:1417967050
Name:UPMC HORIZON
Entity Type:Organization
Organization Name:UPMC HORIZON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-367-6354
Mailing Address - Street 1:PO BOX 382007
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15250-8007
Mailing Address - Country:US
Mailing Address - Phone:412-432-5500
Mailing Address - Fax:
Practice Address - Street 1:110 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1726
Practice Address - Country:US
Practice Address - Phone:412-432-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000204641OtherBC ANTHEM NUMBER
PA000000204646OtherBC ANTHEM NUMBER
PA94OtherUPMC HEALTH PLAN NUMBER
PA0245OtherHIGHMARK PROVIDER NUMBER
PA000000204641OtherBC ANTHEM NUMBER
PA395803Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER