Provider Demographics
NPI:1619096161
Name:THE WESTERN PENNSYLVANIA HOSPITAL
Entity Type:Organization
Organization Name:THE WESTERN PENNSYLVANIA HOSPITAL
Other - Org Name:FORBES REGIONAL CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-858-2372
Mailing Address - Street 1:2570 HAYMAKER RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3513
Mailing Address - Country:US
Mailing Address - Phone:412-858-2000
Mailing Address - Fax:412-858-2088
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-2000
Practice Address - Fax:412-858-2088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE WESTERN PENNSYLVANIA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA311101261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100727720083Medicaid
PA390267Medicare ID - Type UnspecifiedPA MEDICARE PROVIDER NO.