Provider Demographics
NPI:1699840736
Name:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Entity Type:Organization
Organization Name:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Other - Org Name:FAMILY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-778-4606
Mailing Address - Street 1:201 CHESTNUT AVE
Mailing Address - Street 2:HOSPICE
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4927
Mailing Address - Country:US
Mailing Address - Phone:814-946-5411
Mailing Address - Fax:814-942-1673
Practice Address - Street 1:20 SHERATON DR
Practice Address - Street 2:HOSPICE
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9316
Practice Address - Country:US
Practice Address - Phone:814-949-6784
Practice Address - Fax:814-941-1605
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207QH0002X
PA150599251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007OtherHIGHMARK
PA30847OtherGEISINGER
PA1007767800059Medicaid
PA1024960OtherGATEWAY HEALTH PLAN
PA1024960OtherGATEWAY HEALTH PLAN