Provider Demographics
NPI:1881189256
Name:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Entity Type:Organization
Organization Name:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Other - Org Name:SUSQUEHANNA HOME CARE AND HOSPICE SERVICES
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 1:1100 GRAMPIAN BLVD
Mailing Address - Street 2:FOUR SOUTH
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1909
Mailing Address - Country:US
Mailing Address - Phone:570-320-7690
Mailing Address - Fax:570-323-0716
Practice Address - Street 1:1100 GRAMPIAN BLVD
Practice Address - Street 2:FOUR SOUTH
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701
Practice Address - Country:US
Practice Address - Phone:570-723-0760
Practice Address - Fax:570-723-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA700605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007767800071Medicaid