Provider Demographics
NPI:1659777076
Name:INTERIM HEALTHCARE OF PITTSBURGH
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF PITTSBURGH
Other - Org Name:INTERIM HEALTHCARE OF MORGANTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-436-9404
Mailing Address - Street 1:1111 VAN VOORHIS RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2737
Mailing Address - Country:US
Mailing Address - Phone:304-598-8900
Mailing Address - Fax:304-598-7611
Practice Address - Street 1:1111 VAN VOORHIS RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2737
Practice Address - Country:US
Practice Address - Phone:304-598-8900
Practice Address - Fax:304-598-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV027598251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0004609001Medicaid
WV0004609000Medicaid
WV0004609000Medicaid