Provider Demographics
NPI:1649393018
Name:ADAGIO HEALTH INC.
Entity Type:Organization
Organization Name:ADAGIO HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BJ
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-288-2130
Mailing Address - Street 1:960 PENN AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3818
Mailing Address - Country:US
Mailing Address - Phone:412-288-2130
Mailing Address - Fax:
Practice Address - Street 1:960 PENN AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3818
Practice Address - Country:US
Practice Address - Phone:412-288-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAGIO HEALTH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-09
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007284320101Medicaid
PA009211L5TMedicare PIN
PA009257L56Medicare PIN
PA003480PAZMedicare PIN
PA009222L55Medicare PIN