Provider Demographics
NPI:1912383118
Name:CATHOLIC CHARITIES FREE HEALTH CARE CENTER
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES FREE HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ELIGIBILITY SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-456-6949
Mailing Address - Street 1:212 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3517
Mailing Address - Country:US
Mailing Address - Phone:412-456-6949
Mailing Address - Fax:412-456-0128
Practice Address - Street 1:212 9TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3517
Practice Address - Country:US
Practice Address - Phone:412-456-6949
Practice Address - Fax:412-456-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare