Provider Demographics
NPI:1689641847
Name:UPMC/JAMESON CANCER CENTER
Entity Type:Organization
Organization Name:UPMC/JAMESON CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - CANCER SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOGOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-692-2451
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE, N430
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-7706
Mailing Address - Fax:412-432-7691
Practice Address - Street 1:2602 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1537
Practice Address - Country:US
Practice Address - Phone:724-656-4012
Practice Address - Fax:724-656-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012971320001Medicaid
PA1735439OtherHIGHMARK
OH2609056Medicaid
PA1735439OtherHIGHMARK
OH2609056Medicaid