Provider Demographics
NPI:1689679581
Name:ALLE-KISKI MEDICAL CENTER
Entity Type:Organization
Organization Name:ALLE-KISKI MEDICAL CENTER
Other - Org Name:ALLEGHENY VALLEY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-2472
Mailing Address - Street 1:4 ALLEGHENY CENTER
Mailing Address - Street 2:FLOOR 10
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-330-5040
Mailing Address - Fax:724-226-7490
Practice Address - Street 1:1301 CARLISLE STREET
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1152
Practice Address - Country:US
Practice Address - Phone:724-226-7000
Practice Address - Fax:724-226-7490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA790101282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0097OtherHIGHMARK ACUTE
PA1003056OtherGATEWAY HEALTH PLAN
PA390032Medicare Oscar/Certification
PA0088013OtherUNITED MINE WORKERS
PA373558OtherFEDERAL BLACK LUNG
PA6491365OtherAETNA
PA1007447680001Medicaid