Provider Demographics
NPI:1841428430
Name:UPMC COMMUNITY MEDICINE INC
Entity Type:Organization
Organization Name:UPMC COMMUNITY MEDICINE INC
Other - Org Name:MAGEE COMPREHENSIVE BREAST CENTER AT UPMC HORIZON
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0943
Mailing Address - Street 1:875 N HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3278
Mailing Address - Country:US
Mailing Address - Phone:724-347-4847
Mailing Address - Fax:724-347-4782
Practice Address - Street 1:875 N HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3278
Practice Address - Country:US
Practice Address - Phone:724-347-4847
Practice Address - Fax:724-347-4782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042477Medicare PIN