Provider Demographics
NPI:1013984376
Name:MOUNTAIN VIEW CANCER ASSOCIATES
Entity Type:Organization
Organization Name:MOUNTAIN VIEW CANCER ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-648-6777
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE, N430
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-7706
Mailing Address - Fax:412-432-7691
Practice Address - Street 1:200 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3783
Practice Address - Country:US
Practice Address - Phone:724-838-1900
Practice Address - Fax:724-838-5620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RH0003X, 2085R0001X
PA39D0897527291U00000X
PA39D0999301291U00000X
PA39D0906359291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019411140001Medicaid
PA0019411140008OtherCLIA LAB
PA1442920OtherHIGHMARK-MEDICAL ONCOLOGY
PA0019411140005Medicaid
PA0019411140009OtherCLIA LAB
PA0019411140004Medicaid
PA0019411140007OtherCLIA LAB
PA1442304OtherHIGHMARK-RADIATION ONCOLOGY
PA1442920OtherHIGHMARK-MEDICAL ONCOLOGY
PA0019411140009OtherCLIA LAB
PA0019411140001Medicaid
PA4713470004Medicare NSC
PACK7286Medicare PIN
PA0019411140004Medicaid