Provider Demographics
NPI:1609870062
Name:SOUTHWESTERN HEARING CARE, INC.
Entity Type:Organization
Organization Name:SOUTHWESTERN HEARING CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ANGELELLI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-466-5550
Mailing Address - Street 1:500 LEWIS RUN RD
Mailing Address - Street 2:STE 117
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15122-3057
Mailing Address - Country:US
Mailing Address - Phone:412-466-5550
Mailing Address - Fax:412-466-8741
Practice Address - Street 1:500 LEWIS RUN RD
Practice Address - Street 2:STE 117
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15122-3057
Practice Address - Country:US
Practice Address - Phone:412-466-5550
Practice Address - Fax:412-466-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-000196-L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA90735OtherADVANTRA PIN
PA000981818OtherPIN FOR HIGHMARK B/S
PA0492912OtherAETNA USHEALTHCARE
PA000981818OtherPIN FOR HIGHMARK B/S
PA0492912OtherAETNA USHEALTHCARE
PA=========OtherUMWA TAX ID