Provider Demographics
NPI:1821110172
Name:WEST PENN ALLEGHENY HEALTH SYSTEM INC.
Entity Type:Organization
Organization Name:WEST PENN ALLEGHENY HEALTH SYSTEM INC.
Other - Org Name:ALLEGHENY GENERAL HOSPITAL - LIFE FLIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO - ALLEGHENY GENERAL HOSPITAL
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-359-3935
Mailing Address - Street 1:1 5TH AVE FL 14
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3133
Mailing Address - Country:US
Mailing Address - Phone:412-330-6062
Mailing Address - Fax:412-330-6040
Practice Address - Street 1:320 EAST NORTH AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3131
Practice Address - Fax:412-359-4108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST PENN ALLEGHENY HEALTH SYSTEM INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-06
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5301013416A0800X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200097Medicaid
PA390050Medicare ID - Type UnspecifiedPA MEDICARE
PA1007508630024Medicaid