Provider Demographics
NPI:1639339211
Name:ST CLAIR MEMEORIAL HOSPITAL
Entity Type:Organization
Organization Name:ST CLAIR MEMEORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHESNOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-942-1200
Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1899
Mailing Address - Country:US
Mailing Address - Phone:412-942-4558
Mailing Address - Fax:412-942-1271
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1899
Practice Address - Country:US
Practice Address - Phone:412-942-4558
Practice Address - Fax:412-942-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA450501282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007552060019Medicaid